Pathogenesis and Clinical Manifestations of Clostridium difficile Diarrhea and Colitis

  • R. J. Farrell
  • J. T. LaMont
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 250)


Clostridium difficile is a spore-forming, gram-positive anaerobic bacillus discovered in 1935 as a commensal organism in the fecal flora of healthy newborn infants (Hall and O’Toole 1935). The organism was given its name because it grew very slowly in culture and was difficult to isolate in pure culture. Its presence in the stool of 50% of healthy neonates suggested that C. difficile was a commensal not a pathogen, even though it was toxigenic in broth culture. Not long after its original description, C. difficile passed into obscurity until its rediscovery some four decades later. Antibiotic-associated pseudomembranous colitis became prevalent in the 1960s and 1970s with the introduction into clinical practice of broad-spectrum antibiotics. The frequent association of clindamycin and lincomycin therapy with pseudomembranous colitis led to the term “clindamycin colitis” (Tedesco et al. 1974). A breakthrough occurred in 1978 when C. difficile was identified as the source of a cytotoxin found in the stool of patients with pseudomembranous colitis (Bartlett et al. 1978). During the two decades since its rediscovery, a great deal has been learned about the pathophysiology, epidemiology, and management of C. difficile diarrhea, yet many challenges remain. At present this organism continues to infect up to 20% of individuals admitted to hospital, making C. difficile colitis the most common enteric infection in hospital practice (Kelly et al. 1994).


Pseudomembranous Colitis Toxic Megacolon Colonic Microflora Fulminant Colitis Osmotic Diarrhea 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • R. J. Farrell
    • 1
  • J. T. LaMont
    • 1
  1. 1.Division of GastroenterologyBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA

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