A 15-Year-Old Boy on Antibiotics to Clear Up a Community-Acquired

A 15-year-old boy on antibiotics to clear up a community-acquired methicillin-resistant Staphylococcus aureus has clindamycin added to his treatment regimen to slow the production of the various toxins including Panton-Valentine leukocidin. He recovers but develops Clostridium difficile diarrhea. Why does C. difficile cause diarrhea?

A) C. difficile multiplies and causes disease in a mechanism similar to that of Listeria
B) C) difficile multiplies, secreting Shiga toxin during cell lysis
C) C) difficile stacks itself on the colonic surface to cause malabsorption and the appearance of a pseudomembrane
D) C) difficile exotoxins damage the cells, causing a disruption in transport and attracting polymorphonuclear cells to cause the appearance of a pseudomembrane