What is the clinical presentation of C. difficile infection?

• A. Three or more loose or watery stools within 24 hours, with abdominal pain, fever, nausea
• B. Two loose stools in 48 hours with cramps
• C. Blood in stool with tenesmus
• D. Crohn's disease-like abdominal pain with weight loss

Answer: (A)

Clostridioides difficile infection typically presents with acute watery diarrhea, often accompanied by abdominal pain, fever, and nausea. The defining feature is three or more loose stools within a 24-hour period, reflecting toxin-mediated inflammation of the colon. This is why the option describing three or more loose or watery stools in 24 hours, with abdominal pain, fever, and nausea best matches CDI.

The other patterns don’t fit CDI well: two loose stools in 48 hours is below the diarrheal burden that characterizes CDI; blood in stool with tenesmus suggests invasive colitis or dysentery rather than CDI; Crohn’s disease–like abdominal pain with weight loss points to a chronic inflammatory bowel condition rather than an acute CDI episode.