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Clostridium difficile infection in children: Clinical features and diagnosis

Jonathan Crews, MD, MS
Section Editor
Morven S Edwards, MD
Deputy Editor
Mary M Torchia, MD


Clostridium difficile is an important cause of antibiotic-associated diarrhea and one of the most common healthcare-associated infections [1]. It causes a wide spectrum of illnesses from asymptomatic colonization or mild diarrhea to fulminant disease characterized by toxic megacolon, sepsis, and death. C. difficile infection is less common in children than adults, but the incidence of C. difficile infection in children is increasing [2-5].

The clinical features and diagnosis of C. difficile infection in children will be discussed here. The microbiology, pathogenesis, epidemiology, treatment, and prevention of C. difficile infection in children are discussed separately. (See "Clostridium difficile infection in children: Microbiology, pathogenesis, and epidemiology" and "Clostridium difficile infection in children: Treatment and outcome" and "Clostridium difficile infection: Prevention and control".)

C. difficile infection in adults also is discussed separately. (See "Clostridium difficile in adults: Epidemiology, microbiology, and pathophysiology" and "Clostridium difficile infection in adults: Clinical manifestations and diagnosis" and "Clostridium difficile in adults: Treatment".)


The clinical spectrum of C. difficile infection ranges from asymptomatic colonization to fulminant colitis [6,7]. The severity of infection generally increases with age. Mortality and recurrence rates are highest in persons ≥65 years [1]. However, the full spectrum of disease is possible in all age groups [6,8].

Neonates and infants — Asymptomatic colonization with toxigenic C. difficile is common in neonates (<28 days) and infants (<12 months).


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