- When I took antibiotics for a sinus infection, I began feeling weak and feverish, with diarrhea.
- I went to the ER and learned I had Clostridioides difficile, an infection in the large intestine.
- The antibiotics had wiped out the good bacteria; I stopped taking them and was treated for C. diff.
During my family's annual vacation last year, I got COVID-19. Frustrated by having to cancel so many plans, I remember thinking, "At least it can't get much worse than this." As a nurse and mom though, I should have known the possibilities for "worse than this" were endless.
A year later, on the same family vacation to Minnesota, I got sick again and was prescribed the antibiotic Cefdinir for a pesky sinus infection. Thankfully, after the first day, it no longer hurt to swallow, my ear pain disappeared, and I had energy.
Then, on day four of my antibiotics course, I woke up feeling fatigued but chalked it up to traveling with kids. We laid low and watched a movie, stopping for pizza on the way back to our resort. I started having diarrhea but still didn't want to believe I was sick, instead blaming it on the taco pizza we'd had for dinner.
The cause of my symptoms was more serious than I thought
The next morning, I woke up with a fever, chills, and diarrhea. At first it was manageable, but soon it felt as if I would pass out each time I used the bathroom. I had to lie down on the floor and wait for my vision to return before hobbling back to bed. When I wasn't on the toilet, I was kept awake by a crushing migraine and stomach pain.
That night, my husband took me to the emergency room. Due to my low blood pressure and high heart rate, I was seen quickly. They started fluids and anti-nausea medications and took blood and stool samples. When my white-blood-cell count came back high, the doctor poked his head into the room to tell me he was now suspecting Clostridioides difficile — otherwise known as C. diff.
I groaned. I became familiar with C. diff, a bacterium that causes infection in the large intestine, when I worked as a floor nurse. While it doesn't normally infect people with healthy immune systems, people who are immunocompromised are at a much higher risk of contracting it. That's why it can spread like wildfire in places like hospitals and nursing homes if staff aren't properly washing their hands or cleaning supplies that are used in multiple rooms. C. diff can survive for long periods of time, dormant until it enters the gut. It's also resistant to many antibiotics and cleaning solutions.
The antibiotics put me at risk for C. diff
Another risk factor for C. diff is being on antibiotics. Antibiotics, while helpful in curing bacterial infections, can wipe out the good bacteria in the gut, making it easier for bacteria like C. diff to take over. Since my ER doctor knew I was on an antibiotic, he was able to quickly home in on the diagnosis.
Two hours after a saintly nurse walked my stool sample to the lab, another doctor entered my dark room. "Have you heard of C. diff?" he asked. I sighed, "Yeah, I'm a nurse."
"You have it," he said, with a sympathetic smile.
"Shiiiiiiiiiiit," I said.
He laughed, "I know, right?"
He put me on a ten-day course of vancomycin, another antibiotic better suited to fight C. diff, and had me immediately stop the Cefdinir. Dr. Ciarán P. Kelly, a gastroenterologist and professor at Harvard Medical School, said, "Antibiotics alter the normal gut bacteria that offer protection against C. difficile infection — which is why C. difficile infection usually, but not always, happens after antibiotic treatment. It's a bacterial infection, so antibiotics are used to treat it, which is indeed ironic."
For the next ten days, I had diarrhea after consuming anything, even water. C. diff is contagious until 48 hours after the resolution of the diarrhea. For me, it took 13 days. During this time, I used a separate bathroom from the rest of the family or bleached the toilet and sink after I used them. (My nurse in the hospital explained bleach is the only cleaning product that can kill C. diff spores.)
Kelly said that my situation — a young and otherwise healthy person who got C. diff after antibiotic use — is unusual but not rare, and explained that most cases occur in older people.
If you suspect you have C. diff, Kelly recommends seeing your healthcare provider for testing; if your hunch is correct, they may recommend you stop the antibiotic you're on and put you on another one for treatment.