Most commonly, pts develop diarrhea, with stools that are not grossly bloody and are soft to watery, with a characteristic odor. Pts may have up to 20 bowel movements per day. Fever, abdominal pain, and leukocytosis are common.

• Constipation due to an adynamic ileus can occur. Unexplained leukocytosis (≥15,000 WBCs/µL) in this setting should prompt evaluation for CDI. These pts are at high risk for complications such as toxic megacolon and sepsis.
• C. difficile diarrhea recurs after treatment in ~15-30% of cases.