Table 1.

Clinical Features and Complications of Clostridioides difficile Infection

Spectrum of Disease	Diarrhea	Other Symptoms	Physical Examination	Colonoscopic and Other Findings
Asymptomatic carrier	None	None	Normal	Normal
Simple antibiotic-associated diarrhea	Mild	Systemic symptoms usually absent	Usually normal	Normal
Early colitis	Profuse	Nausea, anorexia	Low-grade fever, with or without mild abdominal tenderness	Nonspecific patchy erythema
Pseudomembranous colitis	Profuse	Nausea, malaise, abdominal discomfort	Fever (sometimes high); abdominal tenderness, distention	Pseudomembranes (raised yellow plaques); leukocy-tosis (may be ≥50 × 109 cells/L, with left shift)
Fulminant colitis	Usually profuse and severe; may be absent in ileus or toxic megacolon	Nausea, abdominal discomfort or pain	Toxic appearance, fever (often high); abdominal distention, tenderness, and peritoneal signs	Endoscopy contraindicated in severely ill patients; leukemoid reaction common; radiographic studies may show colonic dilatation, mucosal thickening, or perforation