Pseudomembranous Colitis Quiz
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Diarrhea
Stomachache
Have a fever
Stomachache gets worse when pressed
Bloating
Yellow eyes
Loose stool
Not seeing your symptoms? No worries!
What is Pseudomembranous Colitis?
An infection of the large intestine, typically following antibiotic use. The antibiotics kill both good and bad bacteria, disrupting the normal balance of gut flora.
Typical Symptoms of Pseudomembranous Colitis
- Recent antibiotic use
- Fever
- Blood in stool
- Yellowish eyes or skin
- Stomach or abdominal pain
- Constipation with urge to go but unable to pass stool
- Diarrhea or loose stools
- Stomach pain that worsens when the stomach is pressed
Diagnostic Questions for Pseudomembranous Colitis
Your doctor may ask these questions to check for this disease:
- Are you on antibiotics or have you recently taken any?
- Do you have a fever?
- Have you noticed any blood in your stool?
- Have you noticed any yellowing of your eyes or skin?
- Do you have any stomach or abdominal pain?
Treatment of Pseudomembranous Colitis
It's important to stop the antibiotics causing this infection. After that, another antibiotic that targets the infection is given to kill the harmful bacteria.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Sep 2, 2025
Following the Medical Content Editorial Policy
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- Blood in stool
- White of the eyes are yellow
- My body is hot
- Stools looks like strawberry jam
- Recurrent fevers
- Icterus
- Periodic fever (>100.4°F / 38°C)
- Stool looks like raspberry jelly
- I have lower abdominal pain
- Fever then no fever then fever again
- Poop looks like strawberry jam
- Remittent fever of 102.2°F / 39°C
- Extremely high fever of 106.7°F / 41.5°C or higher
- I have left lower abdominal pain
- Poo looks like currant jelly
See full list
Symptoms Related to Pseudomembranous Colitis
Diseases Related to Pseudomembranous Colitis
FAQs
Q.
Still Hurting? Why Sulfamethoxazole-Trimethoprim is the Medical Next Step
A.
If your symptoms are not improving, sulfamethoxazole trimethoprim is often the next medical step because it blocks bacterial growth in two complementary ways and treats many stubborn infections, including UTIs, kidney infections, and certain skin infections like some MRSA, with improvement often seen in 48 to 72 hours when taken correctly. There are several factors to consider. See below for who should avoid it or adjust dosing, possible side effects and warning signs like severe rash or persistent diarrhea, important drug interactions, safety tips such as hydration and sun protection, and when to contact your doctor if there is no improvement by 72 hours.
References:
* Liu, W. X., et al. "Trimethoprim-sulfamethoxazole for the treatment of methicillin-resistant Staphylococcus aureus infections: a systematic review and meta-analysis." *Clinical Infectious Diseases*, vol. 63, no. 9, 2016, pp. 1184-1191.
* Ambrosioni, J., et al. "Trimethoprim-sulfamethoxazole for the treatment of Nocardia infections: an updated systematic review." *Clinical Infectious Diseases*, vol. 68, no. 9, 2019, pp. 1603-1614.
* Salzer, H., et al. "Trimethoprim-sulfamethoxazole for the treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected patients." *Annals of Respiratory Medicine*, vol. 6, no. 1, 2022, pp. 1-8.
* Lipsky, B. A., et al. "The role of trimethoprim-sulfamethoxazole in the treatment of diabetic foot infections." *The American Journal of Medicine*, vol. 129, no. 10, 2016, pp. 1109-1115.
* Rusu, A., et al. "Trimethoprim-sulfamethoxazole: an update on its clinical utility." *Journal of Clinical Pharmacy and Therapeutics*, vol. 49, no. 4, 2024, pp. 509-520.
Q.
Vancomycin Side Effects? Why Your Body Needs It & Medically Approved Next Steps
A.
Vancomycin is prescribed to fight serious Gram-positive infections such as MRSA and severe C. diff; side effects can include infusion reactions like Red Man Syndrome, kidney effects, rare hearing changes, GI upset with oral dosing, and true allergy, most of which are manageable with slow infusions and close lab monitoring. Know when to call your doctor or seek urgent care, keep all lab checks, stay hydrated, and do not stop early without medical advice; there are several factors to consider that can change your next steps, so see the complete guidance below.
References:
* Patel S, Palakodeti D, Marraffa E, Shah J, Nimmagadda M, DeSimone N, Javia A. Vancomycin in the 21st Century: A Reassessment of Its Role in the Treatment of Serious Gram-Positive Infections. J Clin Med. 2020 Apr 7;9(4):1043. PMID: 32268480.
* De Ryck S, De Coster I, Vanhooren G, Buyle F, Van de Velde J, Van Den Abeele AM. Vancomycin-Associated Nephrotoxicity and Ototoxicity: A Scoping Review. J Clin Med. 2021 Aug 26;10(17):3878. PMID: 34503799.
* Myers C, Chambers RM, Bhakta K, Huesgen E, Li J, Minard LV. Red Man Syndrome Secondary to Vancomycin: A Systematic Review. J Clin Med. 2020 Jul 14;9(7):2229. PMID: 32669466.
* Rybak MJ, Le J, Lodise JA, Levine DP, Bradley JS, Liu A, Mueller BA, Pai MP, Wong B, Gustafson JE, Coplin B, Swaminathan S, Waite EA, Van Schooneveld TC, Shields RK, Murray B, Guervil DJ, Wesolowski B, Rubino CM. Clinical Pharmacokinetics and Pharmacodynamics of Vancomycin: An Update. Clin Infect Dis. 2020 Nov 30;71(11):2949-2959. PMID: 33267597.
* Hamad MA, Alkhubaiz YA, Ali F, Madi M, Alhassan H, Hasan NA, Al-Awadhi R. Therapeutic Drug Monitoring of Vancomycin: A Systematic Review of Guidelines. J Clin Med. 2021 Jan 20;10(2):364. PMID: 33494793.
Q.
Still Sick? Why Ceftriaxone Fails and Medically Approved Next Steps
A.
If you are still sick after ceftriaxone, there are several factors to consider; common reasons include a nonbacterial illness, resistant bacteria, too little or too short a course, an undrained source like an abscess, a different diagnosis, or antibiotic side effects such as C. diff. For timelines and condition-specific clues that can change your next steps, see the complete details below. Next steps are to contact your doctor for reassessment within 48 to 72 hours if you are not improving, get targeted tests and cultures to guide an antibiotic change or procedures if needed, and seek urgent care for red flags like severe abdominal pain, persistent high fever, bloody diarrhea, confusion, or trouble breathing; key details and exceptions are outlined below.
References:
* Marquez C, Chenard Z, Iannuzzi M. Multidrug-Resistant Gram-Negative Bacterial Infections: A Narrative Review of Current Therapeutic Options. Infect Dis Ther. 2023 Dec;12(12):2701-2720. doi: 10.1007/s40121-023-00913-9. Epub 2023 Oct 23. PMID: 37870935.
* Shi C, Wang J. Mechanisms of Antimicrobial Resistance and Rational Development of Novel Antimicrobial Agents. Microbiol Spectr. 2023 Feb 14;11(1):e0304322. doi: 10.1128/spectrum.03043-22. Epub 2023 Jan 26. PMID: 36768783.
* Palmer V, Chisholm SA, Unemo M. Update on treatment options for multi-drug resistant Neisseria gonorrhoeae. Ther Adv Infect Dis. 2022 Jan 10;9:20499361211068228. doi: 10.1177/20499361211068228. PMID: 35057053.
* Li H, Liu Y, Jin M. Extended-spectrum β-lactamases: resistance mechanism, epidemiology, and treatment. Microb Biotechnol. 2021 Jul;14(4):1413-1425. doi: 10.1111/1751-7915.13783. Epub 2021 Mar 18. PMID: 33744955.
* Tamma PD, Aitken SL, Bonomo RA, et al. Infectious Diseases Society of America 2020 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. Clin Infect Dis. 2021 Apr 8;72(7):e169-e192. doi: 10.1093/cid/ciaa1478. PMID: 32979261.
Q.
Infection Not Clearing? Why Your Body Needs Clindamycin & Medically Approved Next Steps
A.
Clindamycin is a targeted antibiotic used when first-line treatments fail, such as with resistant bacteria, penicillin allergy, deep tissue infections, or anaerobic infections; you should start to feel better within 48 to 72 hours, complete the full course, and watch for severe diarrhea that could signal C. diff. If you are not improving, reconnect with your doctor for culture-guided therapy, possible imaging or abscess drainage, and urgent care for red flags; there are several factors to consider, and key details that can shape your next steps are explained below.
References:
* Finegold SM. Clindamycin Revisited: A Review of its Role in the Treatment of Anaerobic Infections. Clin Infect Dis. 2018 Sep 14;67(Suppl 2):S105-S110. doi: 10.1093/cid/ciy519. PMID: 30046647.
* Lewis K. Mechanisms of bacterial persistence and biofilm formation. Annu Rev Microbiol. 2017 Sep 8;71:405-421. doi: 10.1146/annurev-micro-090816-010355. PMID: 28594954.
* Spigaglia P, Facchin D, Gagliardi L, Scaramella R, Cirino P, Nardella M, Pantosti A. Clindamycin resistance in Staphylococcus aureus: mechanisms, prevalence, and therapeutic implications. Future Microbiol. 2018 Mar;13:307-318. doi: 10.2217/fmb-2017-0242. Epub 2018 Jan 10. PMID: 29329712.
* Conlon BP. Strategies to overcome bacterial persistence and multidrug resistance. Curr Opin Microbiol. 2020 Oct;57:114-121. doi: 10.1016/j.mib.2020.04.010. Epub 2020 May 4. PMID: 32332130.
* Domenech M, García-Rodríguez S, de la Fuente-Núñez C. Antibiofilm Strategies: Current Therapeutic Advances and New Targets. Antibiotics (Basel). 2021 Jun 25;10(7):777. doi: 10.3390/antibiotics10070777. PMID: 34208226; PMCID: PMC8300257.
Q.
Is Your Gut Failing? Why C. Diff Persists & Your Medically Approved Next Steps
A.
C. diff often persists because a disrupted gut microbiome, hardy spores, repeat antibiotic exposure, and weakened immunity let it rebound; most people recover with the right treatment, but seek urgent care for severe abdominal pain, high fever, blood in the stool, dehydration, or worsening symptoms. Medically approved next steps include fidaxomicin or oral vancomycin (often as a taper), bezlotoxumab, and fecal microbiota transplant, along with prevention steps like strict handwashing, cautious antibiotic use, hydration, and discussing probiotics with your doctor. There are several factors to consider, and key details that could change your next step are explained below.
References:
* McDonald, L. C., et al. "Clinical practice guidelines for Clostridium difficile infection in adults and children: 2021 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)." *Clinical Infectious Diseases*, vol. 75, no. 1, 2022, pp. e1-e60. DOI: 10.1093/cid/ciab549.
* Im, G. Y., et al. "American College of Gastroenterology (ACG) Clinical Guideline: Fecal Microbiota Transplantation for Clostridioides difficile Infection." *The American Journal of Gastroenterology*, vol. 118, no. 5, 2023, pp. 805-822. DOI: 10.14309/ajg.0000000000002220.
* Smits, W. K., et al. "Molecular mechanisms of Clostridioides difficile recurrence." *Nature Reviews Microbiology*, vol. 21, no. 1, 2023, pp. 18-34. DOI: 10.1038/s41579-022-00782-z.
* Deshpande, A., & Jain, R. "Recurrent Clostridioides difficile Infection: Evolving Paradigms in Diagnosis and Management." *Infectious Disease Clinics of North America*, vol. 36, no. 3, 2022, pp. 643-659. DOI: 10.1016/j.idc.2022.05.003.
* O'Neal, M. A., & Crooks, J. A. "*Clostridioides difficile* and the Microbiome: Current Understanding of Pathogenesis and Recurrence." *Microorganisms*, vol. 10, no. 10, 2022, p. 1960. DOI: 10.3390/microorganisms10101960.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
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https://www.sciencedirect.com/science/article/abs/pii/S0011502915000073?via%3DihubGollol Raju NS, Jayananda S, Ali E, Harvin G. Am J Ther. 2021 Jul-Aug 01;28(4):e492-e493. doi: 10.1097/MJT.0000000000001068. PMID: 34228655.
https://journals.lww.com/americantherapeutics/Citation/2021/08000/Phentermine_Associated_Pseudomembranous_Colitis.12.aspxIshizawa R, Mori N. Pseudomembranous Colitis Due to Intestinal Amebiasis. Intern Med. 2021 Oct 15;60(20):3335-3336. doi: 10.2169/internalmedicine.7230-21. Epub 2021 Apr 26. PMID: 33896868; PMCID: PMC8580757.
https://www.jstage.jst.go.jp/article/internalmedicine/60/20/60_7230-21/_articleTang DM, Urrunaga NH, von Rosenvinge EC. Pseudomembranous colitis: Not always Clostridium difficile. Cleve Clin J Med. 2016 May;83(5):361-6. doi: 10.3949/ccjm.83a.14183. PMID: 27168512.
https://www.ccjm.org/content/83/5/361