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- Enterotoxin A ® chemotactic for neutrophils, stimulating the infiltration of polymorphonuclear neutrophils into the ileum with the release of cytokines also produces a cytopathic effect, resulting in disruption of the tight cell-to-cell junction, increased permeability of the intestinal wall, and subsequent diarrhoea- Cytotoxin B ® causes actin to depolymerise, with the resultant destruction of the cellular cytoskeleton- Adhesion factor- Hyaluronidase- Spore formation- Fecal-oral, uptaking spores- Asymptomatic colonisation- Antibiotic-associated colitis ® acute diarrhoea generally develops 5 to 10 days after initiation of antibiotic treatment (particularly clindamycin, penicillins, cephalosporins, and fluoroquinolones); it may be brief and self-limited or more protracted- Pseudomembranous colitis ® the most severe form of C. difficile infection; profuse diarrhoea, abdominal cramping, and fever; whitish plaques (pseudomembranes) over intact colonic tissue seen on colonoscopy

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