Clostridioides difficile infection (CDI) is the culprit of millions of nosocomial infections in the United States. Programsthat successfully decrease its incidence, therefore, render cost savings for the healthcare system. Toxic megacolon andperforation are two of the most significant complications with increased mortality rates. We report a 23-year-old nursinghome resident hospitalized for fever, cough, and green sputum. After 3 days of antibiotic therapy, he developed abdominaldistension, diarrhea, and vomiting and underwent a total colectomy. The colon was dilated to a maximum of 11 cmwith markedly edematous mucosa and yellow pseudomembranes. Qualitative PCR of the stool detected Clostridioidesdifficile toxin B gene. While there is no consensus for the required interval between antibiotic treatment and CDI, thispresentation 3 days after starting the antibiotic therapy is earlier than most proposed ranges
