Which of the following is a recognized infectious cause of diarrhea in tube-fed patients?

• A. Clostridium difficile infection
• B. Constipation
• C. Fluid restriction
• D. Narcotic usage

Answer: (A)

When diarrhea occurs in someone receiving tube feeds, infectious causes common to healthcare settings are a key consideration, with Clostridium difficile infection standing out as a primary example. C. difficile often follows antibiotic use and disruption of normal gut flora, leading to toxin-mediated inflammation of the colon and watery diarrhea, sometimes accompanied by fever and abdominal pain. In the tube-fed, hospital-associated population, risk factors like recent antibiotic exposure, age, and healthcare contact heighten the likelihood of this infection. Diagnosis is typically via stool testing for C. difficile toxins or toxin genes, and management centers on stopping the inciting antibiotic when possible and starting targeted therapy such as oral vancomycin or fidaxomicin, along with appropriate infection-control precautions to prevent spread.

Other options listed do not represent infectious diarrhea patterns in this setting: constipation and narcotic use tend to cause reduced stool frequency or constipation, while fluid restriction is more likely to contribute to dehydration or other noninfectious issues rather than an infectious diarrheal process in tube-fed patients.