What symptom is least likely to be associated with a C. difficile infection?

In the context of Clostridium difficile (C. difficile) infection, watery diarrhea and fever are common and classic symptoms. C. difficile primarily causes gastrointestinal disturbances, with diarrhea being a hallmark of the infection due to the toxins it produces, leading to inflammation of the intestinal lining.

Fever can occur as a response to the infection, indicating an inflammatory process in the body. Hyperactive bowel sounds may also be observed as the gut responds to the inflammation and disruption caused by the infection.

On the other hand, severe abdominal epigastric pain is not typically associated with C. difficile infections. While patients may experience abdominal discomfort or cramping, particularly in the lower abdomen, the intense and debilitating nature of epigastric pain is more commonly linked to conditions such as peptic ulcer disease or pancreatitis. Therefore, the presence of severe abdominal epigastric pain is least likely to be seen in a patient with a C. difficile infection, making it the correct answer in this context.