SummaryWe present a unique case of a 82 years old women, with this newly described condition called "pseudomembranous enterocolitis cured with three transplants of intestinal microbi0ta (imt)." We evaluated the case of gaw, who had a perforates sigmoid diverticulum 10m days ago and had surgery with sigmoid resection, colostomy and hartmann's pouch. Her progress was good. However, she was given metronidazole and vancomycin, antibiotics that caused severe diarrhea and toxic state, a week postoperatively. Histopathological study of surgical specimen showed colonic mucosa extensively ulcerated and granulation tissue, fibrin and abundant neutrophils. Submucosal edema and acute periserositis. The muscular and mucosal layer had not alterations. A diagnosis of pseudomembranous enterocolitis (pm) was made. The patient had a toxic state, semi-conscious, diaphoretic and extensive erythema in the right forearm, with minor erythema at the left forearm and face, as well as perineal erythema, third degree edema in lower limbs, dehydrated and chest x-ray showed interstitial pneumonitis. She had a typical case of pm, and proceeded to perform an intestinal microbiota transplantation (imt) from healthy donors at clinical and laboratory studies. After that imt we performed colonoscopy, which showed at the course of transverse and right colon multiple plaques of whitish, cotton-like appearance, which protuded on the mucosal surface. This appearance were also seen at the left colon. We applied 400 ml. Of imt in the right colon and 100 ml at the hartmann's pouch of rectum. At the colonoscopy we placed a foley's catheter with an inflated balloon 20 ml. Also, solid petroleum jelly was left to prevent imt elimination. We removed all antibiotic treatment and replaced with probiotics, through the nasogastric tube.Three day later the patient had a better general condition, was conscious, with erythema limited to forearms, face and perineum, the lowers limb had no edema and she was better hydrated.The second imt was performed with another 400 ml. Of microbiota in right colon and 100 ml. At the hartmann's pouch. To prevent imt a 20 ml. Inflated balloon colostomy (foley's catheter) sealed with solid petroleum jelly.Three days later, a new imt was required under the same conditions as the former two imt. On this occasion the patient was fully aware, speaking and responded correctly to our questions. She had no erythema in her body, no edema at her legs and her chest x-ray had no pneumonitis, and showed only a small leak at the base of right lung.Further treatment without antibiotics, was with symbiotic by mouth and was under another treating team.We reviewed the literature, and we hope to encourage colleagues to use this procedure, which had similar results in the world. Presentation of the caseGaw, female, 82 years old with a history of sigmoid diverticulum perforation, peritonitis treated with sigmoid resection, colostomy and hartmann's pouch were given the following antibiotics: metronidazole, vancomycin which caused pseudomembranous enteroc...
A thorough review of how microbial dysbiosis of different regions impacts on health. The dysbiosis of the Intestinal Microbiota stands out, since it is the one that occupies the highest percentage and, where the greatest number of investigations have been carried out. The different axes that have sprung from the studies are determined, highlighting the brain-gut microbiota axis. The various bi-directional communications between the microbiota and the different organs are analyzed and as this communication is significant in the loss of health.
In the history of humanity, the first TMF was made in the 4th century BC. C. During the Dong-jin Chinese dynasty, the physician Ge Hong described the oral administration of a suspension prepared from human feces in patients with food poisoning or severe diarrhea with good results. In the sixteenth century, during the Ming Dynasty, Li Shi Zhen described in the book of traditional Chinese medicine Ben Cao Gang Mu (Compendium of Materia Medica), the prescription of faecal suspensions (fermented or fresh) and dried faeces for the treatment of diseases abdominals that occur with diarrhea, fever, pain, vomiting and constipation. For aesthetic reasons, doctors labeled these preparations as "yellow soup." The Italian doctor Fabricius Aquapendente, in the seventeenth century, referred to IMT as transfaunation and used it in veterinary medicine. The TMI was used by German soldiers to treat bacterial dysentery during World War II. In the year 1958, Eisman et al. They publish the first article in which four patients with pseudo-membranous colitis were treated with TMF (1). The IMT has generated a change in the perspective of the treatment of multiple diseases. Mark Smith says "We have more than 130 samples ready to use", who after graduating in Microbiology at the Massachusetts Institute of Technology has set up OpenBiome, where faeces, mixed with glycerol so they do not spoil, are stored cold (2). Our group was the first to carry out the TMI in Mexico, in patients not carrying Clostridium difficile, as reported in the Journal Surgery and Surgeons. Vol.86: No. 3. 2018. Zamudio TA, Bermúdez RH, Lezama GH, Guevara OM, Solares EI, Sosa LF. BREAKING PARADIGMS. INTESTINAL MICROBIOTE TRANSPLANT. PRELIMINARY REPORT. http://dx.doi.org/10.1016/j.circir.2016.11.017 Keywords: Fecal microbiota transplantation (FMT); Intestinal microbiota (IM); Intestinal microbiota transplantation (IMT). Microbiota microbioma
Definitely the statement that the different axes substantially influence not only bidirectional communication, but health and disease, is evident. In the near future there will be both axes as organs and almost all will be related to the activity of the Intestinal Microbiota. Generating a personal diet is a good recipe. Prescribing pre, pro or symbiotics is appropriate. Producing modulation of the Intestinal Microbiota, together with the two premises indicated, is a promising future for the correction of many conditions. Keywords: Intestinal microbiome; Intestinal microbiota; Axis microbiota; Intestinal microbiota Transplantation (IMT)
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