Symptoms

Some people carry C. difficile bacteria in their intestines but never become sick. These individuals are carriers of the bacteria and may spread infections.

Signs and symptoms usually develop within 5 to 10 days after starting a course of antibiotics. However, they may occur as soon as the first day or up to three months later.

Mild to moderate infection

The most common signs and symptoms of mild to moderate C. difficile infection are:

• Watery diarrhea three or more times a day for more than one day
• Mild abdominal cramping and tenderness

Severe infection

People who have a severe C. difficile infection tend to become dehydrated and may need to be hospitalized. C. difficile can cause the colon to become inflamed and sometimes form patches of raw tissue that can bleed or produce pus. Signs and symptoms of severe infection include:

• Watery diarrhea as often as 10 to 15 times a day
• Abdominal cramping and pain, which may be severe
• Rapid heart rate
• Dehydration
• Fever
• Nausea
• Increased white blood cell count
• Kidney failure
• Loss of appetite
• Swollen abdomen
• Weight loss
• Blood or pus in the stool

C. difficile infection that is severe and sudden, an uncommon condition, may also cause intestinal inflammation leading to enlargement of the colon (also called toxic megacolon) and sepsis. Sepsis is a life-threatening condition that occurs when the body's response to an infection damages its own tissues. People who have these conditions are admitted to the intensive care unit.

When to see a doctor

Some people have loose stools during or shortly after antibiotic therapy. This may be caused by C. difficile infection. See your doctor if you have:

• Three or more watery stools a day
• Symptoms lasting more than two days
• A new fever
• Severe abdominal pain or cramping
• Blood in your stool