A Case of Toxic Megacolon Caused by Clostridium difficile Infection and Treated with Fecal Microbiota Transplantation

Gweon, Tae‐Geun; Lee, Kyung Jin; Kang, Dong Hoon; Kim, Kyung Hoon; Seong, Hyeon Jin; Ban, Tae Hyun; Moon, Sung Jin; Kim, Jin Su; Kim, Sang Woo

doi:10.5009/gnl14152

Cited by 32 publications

(36 citation statements)

References 12 publications

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“…Despite its excellent outcomes in treating refractory/relapsing CDI, it has not been widely performed in South Korea. However, we were able to find a few cases [8][9][10] and one case series 11 in the Korean literature. Despite minimal publications regarding the use of FMT, its acceptance appears to be growing.…”

Section: Discussionmentioning

confidence: 88%

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Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients

Bang

Park

Kim

et al. 2017

Korean J Gastroenterol

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Background/Aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. Results: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. Conclusions: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea. (Korean J Gastroenterol 2017;69: 226-231)

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Section: Discussionmentioning

confidence: 88%

“…7 However, despite growing interest in FMT to treat refractory/relapsing CDI, it has not been widely used in Korea. We were able to find several cases [8][9][10] and one case series 11 in the literature. We share our experiences of nine patients with recurrent/relapsing CDI who were successfully treated using FMT.…”

Section: Introductionmentioning

confidence: 85%

Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients

Bang

Park

Kim

et al. 2017

Korean J Gastroenterol

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“…We have previously urged physicians to implement FMT before the fulminant stage to minimize patient suffering, morbidity and mortality and healthcare-related costs [9]. However, FMT has now been successfully employed in a handful of acute, severe and fulminant CDI cases [12,14,[45][46][47][48]. In fact, the first published case series of FMT was in (what we now know to be) refractory pseudomembranous colitis by Eiseman et al (1958) [10].…”

Section: Fulminant Cdi/toxic Megacolonmentioning

confidence: 98%

Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

Borody

Fischer

Mitchell

et al. 2015

Expert Review of Gastroenterology & Hepatology

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At its height, the Clostridium difficile infection epidemic caused approximately 7000 infections and 300 deaths per day in the USA. Fecal microbiota transplantation (FMT) has demonstrated extraordinary clinical resolution, C. difficile infection cure rates of over 90%, and low recurrence. In tandem with the rise of FMT, the gastrointestinal microbiome has emerged as a 'vital' organ armed with a wealth of microbe 'soldiers' more powerful than known antibiotics. FMTs' reputation has diffused into many new 'indications' yet these appear to be merely the tip of the iceberg when considering its potential applications. FMT as a therapeutic tool has evolved from the original format of blended donor stool and moved towards a refined product comprising a myriad of microbial components, presented aesthetically as encapsulated lyophilized powder.

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“…However, the data on the use of this method in fulminant C. difficile colitis are limited. Recently, a successful treatment with fecal microbiota transplantation in patients with C. difficile -induced toxic megacolon was reported [9] . In addition, a small report indicates that the combination of FMT with antibiotic therapy with fidaxomicin could represent an important therapeutic option in patients with severe C. difficile colitis [10] .…”

Section: Discussionmentioning

confidence: 99%

Successful Therapy of Severe Pseudomembranous Clostridium difficile Colitis Using a Combination of Fecal Microbiota Therapy and Fidaxomicin

Konturek

Haziri²,

Helfritzsch³

et al. 2016

Med Princ Pract

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Objective: The aim of this work was to describe the use of a combination of fidaxomicin and fecal microbiota therapy (FMT) in Clostridium difficile infection (CDI). Clinical Presentation and Intervention: A 78-year-old female, who was admitted for surgery due to acute diverticulitis caused by postoperative complications and broad antibiotic therapy, developed CDI-induced colitis. Despite the introduction of metronidazole and vancomycin therapy, her clinical condition continued to deteriorate. She was transferred to the intensive care unit where FMT followed by fidaxomicin were performed because her C-reactive protein and leucocyte levels remained elevated. Further clinical improvement and the resolution of colitis was observed. Conclusion: In this case, severe CDI colitis was successfully treated with the combination of FMT and fidaxomicin.

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A Case of Toxic Megacolon Caused by Clostridium difficile Infection and Treated with Fecal Microbiota Transplantation

Cited by 32 publications

References 12 publications

Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients

Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients

Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

Successful Therapy of Severe Pseudomembranous Clostridium difficile Colitis Using a Combination of Fecal Microbiota Therapy and Fidaxomicin

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