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Successful Treatment of Fulminant Clostridium difficile Infection with Fecal Bacteriotherapy

2008; American College of Physicians; Volume: 148; Issue: 8 Linguagem: Inglês

10.7326/0003-4819-148-8-200804150-00024

1539-3704

David You, M. Alaric Franzos, Robert P. Holman,

Gastrointestinal motility and disorders

Letters15 April 2008Successful Treatment of Fulminant Clostridium difficile Infection with Fecal BacteriotherapyDavid M. You, MD, M. Alaric Franzos, MD, and Robert P. Holman, MDDavid M. You, MDFrom National Naval Medical Center, Bethesda, MD 20889, and Virginia Hospital Center, Arlington, VA 22205., M. Alaric Franzos, MDFrom National Naval Medical Center, Bethesda, MD 20889, and Virginia Hospital Center, Arlington, VA 22205., and Robert P. Holman, MDFrom National Naval Medical Center, Bethesda, MD 20889, and Virginia Hospital Center, Arlington, VA 22205.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-8-200804150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: A subset of patients with Clostridium difficile–associated diarrhea will develop fulminant, life-threatening C. difficile infection that is refractory to medical therapy. Surgical options for fulminant disease are associated with high mortality rates. We describe a patient with fulminant C. difficile infection successfully treated with donor stool by retention enema.Objective: To describe a successful case of using fecal bacteriotherapy to treat life-threatening, fulminant C. difficile enterocolitis.Case Report: A 69-year-old man was admitted to the hospital after undergoing radical prostatectomy. The patient was given perioperative, intravenous cefazolin. On postoperative day 2, the patient developed an ileus and oliguric renal ...References1. Dallal RM, Harbrecht BG, Boujoukas AJ, Sirio CA, Farkas LM, Lee KK, et al. Fulminant Clostridium difficile: an underappreciated and increasing cause of death and complications. Ann Surg. 2002;235:363-72. [PMID: 11882758] CrossrefMedlineGoogle Scholar2. Koss K, Clark MA, Sanders DS, Morton D, Keighley MR, Goh J. The outcome of surgery in fulminant Clostridium difficile colitis. Colorectal Dis. 2006;8:149-54. [PMID: 16412077] CrossrefMedlineGoogle Scholar3. Aas J, Gessert CE, Bakken JS. Recurrent Clostridium difficile colitis: case series involving 18 patients treated with donor stool administered via a nasogastric tube. Clin Infect Dis. 2003;36:580-5. [PMID: 12594638] CrossrefMedlineGoogle Scholar4. Persky SE, Brandt LJ. Treatment of recurrent Clostridium difficile-associated diarrhea by administration of donated stool directly through a colonoscope. Am J Gastroenterol. 2000;95:3283-5. [PMID: 11095355] MedlineGoogle Scholar5. Tvede M, Rask-Madsen J. Bacteriotherapy for chronic relapsing Clostridium difficile diarrhoea in six patients. Lancet. 1989;1:1156-60. [PMID: 2566734] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From National Naval Medical Center, Bethesda, MD 20889, and Virginia Hospital Center, Arlington, VA 22205.Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the U.S. Department of the Navy, U.S. Department of Defense, or the U.S. government.Disclosures: None disclosed. 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