No abstract

Background and Aim Fecal microbiota transplantation (FMT) has been proposed as a treatment option for patients with recurrent Clostridium difficile ( C. difficile ) infection but remains a novel option. We examined if FMT is an effective means of treating recurrent C. difficile infection. Methods A retrospective review of 35 patients who underwent FMT was completed. Demographics and other variables, including the use of proton pump inhibitor therapy and history of inflammatory bowel disease, were collected. Results Twenty‐five patients (71.4%) belonged to a high‐risk population (working in a hospital setting, rehabilitation center, or nursing facility) and a total of 74.3% of patients ( n = 26 patients) had no history of proton pump inhibitor use. Twenty‐five patients (71.4%) had used metronidazole prior to transplantation, 35 patients (100%) had used vancomycin, and 7 patients (20%) had used fidaxomicin for prior infection. Four patients (11.4%) had used all three antibiotics during prior treatment. Of the eight patients who had a history of inflammatory bowel disease, six (75%) experienced resolution of symptoms after transplantation. A total of 30 patients (85.7%) had resolution of their symptoms 6–8 weeks’ posttransplant, while 5 patients (14.3%) continued to have symptoms. Conclusions Our retrospective chart review supports that patients benefit from FMT in the setting of recurrent C. difficile infection.

The authors report a case of a collision tumor composed of a primary gastric rhabdomyosarcoma intermingled with an adjacent infiltrating gastric adenocarcinoma. Only eight cases of gastric rhabdomyosarcoma have been reported previously and little information is recorded about the behavior of this tumor. Gastric rhabdomyosarcoma has several distinctive clinical features. It is a highly aggressive tumor (median survival, 2.5 months) occurring in both children and adults and frequently presents as metastatic disease to lung or cervical lymph node. The initial diagnosis is often difficult to establish, especially on biopsy material. In several instances, the correct diagnosis was established only at autopsy. The authors' patient was correctly diagnosed during life and received considerable benefit from cyclophosphamide, doxorubicin, and vincristine (CAV) therapy and survived for 26 months after diagnosis. Two of the previously reported eight cases of primary gastric rhabdomyosarcoma and this case have adjacent admixed glandular gastric adenocarcinomas. Since three of the nine known cases of primary gastric rhabdomyosarcoma have an adjacent admixed gastric adenocarcinoma, there appears to be a greater than chance association between these two tumors.

No abstract