Basic and clinical aspects of Clostridium difficile colitis.

Clostridium difficile, a gram-positive anaerobic bacillus dubbed as the difficult clostridium because it resisted early attempts of isolation and culture. After some decades in the darkness, it became famous, when in 1978, a cytotoxin of the C. difficile was found the responsible of the pseudomembranous colitis. We review in this paper aspects of the epidemiology of the C. difficile in health and disease. Also the importance of C. difficile as a cause of nosocomial infections. We review the characteristics of the toxins A and B produced by the pathogenic strains of C. difficile. Finally, clinical aspects of infection with C. difficile in special in the pseudomembranous colitis. The diagnosis, medical therapy, complications and surgical indications are briefly described.