Clostridium Difficile (C Diff) is an intestinal bacterium that has been wreaking havoc in hospitals and infection control departments. It is what is known as a nosocomial infection – an infection obtained while in hospital from infectious spread from other patients. One of the most significant challenges with C Diff is the delay in detection. Nurses are instrumental in early identification and isolation of infected patients decreasing the risk of transmission to more patients.
Many nurses swear that they can identify patients with C Diff by the smell of their stool alone. Research studies have even been able to identify the volatile organic compounds that are unique to patients with C Diff supporting this theory. Other studies have shown that nurses can accurately identify C Diff stools by odor in up to 84% sensitivity and 77% specificity. In controlled laboratory settings, however, where the nurses were blind to patient characteristics (presence of diarrhea, antibiotic use, etc.) these results were not replicated. This means that while a nurse’s prediction of a positive C Diff culture may be reliable, it is not based solely on smell alone.
One of the newest and more entertaining breakthroughs with C Diff detection is the advent of C Diff sniffing dogs. In one Dutch hospital, a two-year-old beagle was trained to smell C Diff and was found to be accurate in 265 out of 270 cases.
The unique scent of C Diff obviously exists and is quite specific to this particular infection. Many nursing students or new nurses are left wonder what that smell is so that they can try to identify it. While descriptions of the scent can help, nothing beats real life experience!
Here are a few descriptions that experienced nurses have used to describe the unique odor of a C Diff infection.
C Diff Smells Terrible
While not as descriptive, it is universally agreed upon that C Diff smells simply terrible.
“Absolutely terrible!! Normal feces are bad enough, but C Diff stools are simply revolting.”
“If you walk into a patient’s room after they go to the restroom, and you smell something that makes you want to hurl all the way into next week, then it is safe to suspect your patient has C Diff.”
“Can’t really do it justice. It’s very foul and loud, and once you have smelled it, you will never forget it.”
C Diff smells like a Barnyard
One of the other most common descriptions is the smell of manure or a barnyard.
“I call it that “barnyard” smell, like rotting manure.”
“A pig pen or decomposing bodies smell like Chanel No. 5 compared to C-Diff.”
“Earthy…almost like the smell of compost…but worse.”
“Nastiest piggy/sour chicken barnyard smell ever.”
C Diff smells Moldy
Often nurses state that C Diff smells slightly fermented or moldy.
“Moldy…like stale bread…tinged with a little skunk…and allowed to ferment.”
C Diff smells like an Outhouse
While bathrooms never smell good after a bowel movement, anyone who has ever used an outhouse knows that they have a particularly horrible stench. Many times, the smell of C Diff can be compared to the distinctive smell of an outhouse.
“It smells like using an outhouse or J-John during 3 months of 110+ degree temperature days. It does not smell like normal poop; it smells like something that has been dead and laying in the hot sun with just a slight tang of poop smell.”
C Diff Smells like Rotten Meat
Often C Diff is compared to the smell of meat that has gone off.
“To me, it is that rotten chicken meat smell (like when you smell that chicken and go…no way…can’t make this tonight!)”
“I think it smells like road kill on a 100-degree day mixed with silent but deadly flatus.”
“I think C Diff smells like a mixture of Texas road kill in the summer plus the dirty feather odor of the vultures that come to strip the edible parts from the rotting carcass.”
“It smells like something crawled up there and died…”
“I always think “rancid meat” when I smell C Diff.”
C Diff smells like a Swamp
Much like the earlier musty smell, C Diff is often described as smelling like a swamp
“C Diff to me smells swampy.”
C Diff Smells Sickly Sweet
Often C Diff is described as slightly sweet.
“It has almost a sickly-sweet smell…once you smell it, you will not forget.”
C Diff Smells Fishy
Some feel like C Diff has a slightly fishy odor.
“C Diff smells almost…fishy, there is a slight undertone of fishiness to it.”
C Diff Smells like Baby Poop
Often nurses have likened it to the smell of baby poop.
“It smells like the sickly-sweet smell of babies diapers…but 100 times worse.”
C Diff is a Smell that Sticks with You
One of the hallmark comments on the smell of C Diff is that it is a smell that seems to stick with you for the rest of the day and when you go home.
“I always feel like I still have that C Diff smell on me when I get home.”
“It seems to have the unique quality that if you ever empty a bedpan or wipe a bottom of someone that has it, you will smell like it for the rest of your shift, even though you wore gloves and washed your hands ten times.”
“The smell lingers for hours, days.”
With all these colorful and sometimes entertaining descriptions, one can imagine what C Diff smells like, and it can possibly help to identify an infection before waiting for lab results. While descriptions are never a replacement for experiencing it for yourself, it can help new nurses or nursing students to identify this unique and unmistakable scent.
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Frequently Asked C Diff Smell Questions and Answers
C diff is often described as sickeningly sweet smelling feces. However, there are many different descriptions for the smell of Clostridioides difficile poop.
C. Diff diarrhea always has a strong odor. If you have c diff or take care of a patient with it, the smell will be very apparent.
According to the CDC, signs and symptoms of c diff include: Diarrhea including loose, watery stools (poop) or frequent bowel movements for several days, fever, stomach tenderness or pain, loss of appetite, and Nausea.
C diff is highly contagious and can be spread by direct contact with contaminated objects and surfaces. C diff is spread via the fecal-oral route, meaning they touch something that has the c diff bacteria on it and then their mouths. A good reminder to frequently was your hands.
C diff is frequently caused by antibiotics wiping out healthy gut flora allowing bad bacteria to take over. The antibiotics that commonly lead to c diff are clindamycin (for example, Cleocin),
fluoroquinolones (for example, levofloxacin [Levaquin], ciprofloxacin [Cipro, Cirpo XR, Proquin XR]),
penicillins, and. cephalosporins.
C diff is often described as producing sweet smelling poop. If you’ve taken antibiotics recently or been exposed to someone with C. diff, you should speak with your primary care provider.
C diff has been described as producing poop that smells like skunk. You should speak with your primary care provider if your poop smells like skunk.
If your poop smell sweet, you may have c diff, which is a bacterial infection of the colon.
According to the Mayo Clinic, “Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), also known as Clostridioides difficile and often referred to as C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.”
Although the smell of sweet smelling poop is usually an indicator of c diff, it’s not always detectable by smell. A research study revealed that nurses were only able to positively identify c diff by smell about 45% of the time. This accuracy was not impacted by experience of the nurse of their confidence in their ability to smell c diff. Even if swear you can’t smell c diff, you might predict it just as accurately as a nurse claiming they are a c diff poop smelling pro.
If you think your poop smells like fish, you should see your primary care provider. Though c diff can be described as smelling like a fish, there are other medical conditions that can be the cause. Regardless of the diagnosis, you’ll want to get checked out because poop that smells like fish should not be routine.
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