What are the symptoms of Clostridioides difficile (C. difficile) infection?

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Last updated: February 27, 2025View editorial policy

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Differential Diagnosis for Symptoms of C. difficile

  • Single most likely diagnosis
    • Clostridioides difficile infection: This is the most likely diagnosis given the symptoms, as C. difficile is a common cause of diarrhea, abdominal pain, and fever, especially in patients who have recently used antibiotics or have been hospitalized.
  • Other Likely diagnoses
    • Viral gastroenteritis: Other viruses such as norovirus or rotavirus can cause similar symptoms and should be considered, especially if there is a history of exposure to someone with similar symptoms.
    • Bacterial gastroenteritis: Bacteria such as Salmonella, Shigella, or E. coli can cause diarrhea, abdominal pain, and fever, and should be considered, especially if there is a history of food poisoning or travel.
    • Inflammatory bowel disease (IBD): Conditions such as Crohn's disease or ulcerative colitis can cause chronic diarrhea, abdominal pain, and weight loss, and should be considered if the symptoms are persistent or recurrent.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Toxic megacolon: A life-threatening complication of C. difficile infection or other conditions such as IBD, characterized by a very inflated colon that can rupture and cause peritonitis.
    • Bowel obstruction: A blockage of the intestine that can cause severe abdominal pain, vomiting, and constipation, and requires prompt surgical intervention.
    • Ischemic bowel disease: A condition where the blood flow to the intestine is reduced, causing abdominal pain, diarrhea, and potentially life-threatening complications if not treated promptly.
  • Rare diagnoses
    • Whipple's disease: A rare bacterial infection that can cause diarrhea, abdominal pain, and weight loss, and is often diagnosed by intestinal biopsy.
    • Lymphoma or other malignancies: Rarely, diarrhea and abdominal pain can be symptoms of a lymphoma or other malignancy, and should be considered if the symptoms are persistent or recurrent and other causes have been ruled out.
    • Intestinal parasitic infections: Infections such as giardiasis or amoebiasis can cause diarrhea, abdominal pain, and weight loss, and should be considered if there is a history of travel to endemic areas.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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