I can tell by these symptoms that I’m diseased

In order to have an increased risk for the disease at all, one must have received a long-term antibiotic therapy beforehand. This often applies to ENT patients, people with pneumonia and patients after artificial joint inflammation. If bloody diarrhoea occurs after several weeks of antibiotic therapy and there is cramp-like abdominal pain, a doctor should be consulted.

A high fever during the illness is also typical. The diarrhoea has a characteristic bad smell and a high frequency. Due to the high loss of water, the affected persons feel flabby and the skin can remain in wrinkles. In severe cases, consciousness may also be impaired. The course of a severe infection can be very rapid, so that there are only a few hours between slight discomfort and intensive care.

Toxin A

In order for Clostridium difficile to cause disease at all, the bacterium must produce toxins. Strains that are unable to do so are regarded as apathogenic, i.e. harmless. Not all strains of bacteria produce the same toxins and therefore there are some cases where no toxin A is produced.

Toxin A, an enterotoxin, is considered the less important toxin for clostridia-induced diarrhoea. Enterotoxins are proteins that are secreted by the bacteria and are toxic to the intestinal cells. Toxin A can make holes in the cell wall and thus either kill the intestinal cells directly or form an entry portal for other toxins.

Toxin A also has a chemotactic effect on certain immune cells, the so-called neutrophils. This means that the toxin influences the movement of the immune cells. Toxin A acts via a change in the cytoskeleton of the cells and can thus also change their shape.

Toxin A does not normally occur alone, but is accompanied by Toxin B. The probability of the host becoming ill increases if the immune system does not react sufficiently to Toxin A. Most adults have antibodies against Toxin A, as contact with the pathogen has often occurred during infancy.

Toxin B

Toxin B is the second toxin produced by Clostridium difficile. This is a cytotoxin. In some patients, only Toxin B is present, which is why it is assumed that Toxin B is the more important factor in Clostridium difficile disease. Toxin B also attacks the cytoskeleton, which gives the intestinal cells their shape. The laboratory chemical test procedures for a Clostridium infection are particularly specialised on Toxin B, as this is more common than Toxin A.

Incubation period

Since Clostridium difficile can also be detected in healthy people and only becomes active after certain environmental influences have occurred, no maximum incubation period can be stated. Some people carry Clostridium difficile in their intestines all their lives without ever becoming ill. However, after initial infection, the bacterium must first reproduce sufficiently to cause disease.