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Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection.

Jeon YD, Hong N, Kim JH, Park SH, Kim SB, Song IJ, Ann HW, Ahn JY, Kim SB, Ku NS, Lee K, Yong D, Kim JM, Choi JY - Infect Chemother (2016)

Bottom Line: The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise.Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains.Furthermore, antibiotic therapy results in recurrence rates of at least 20%.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. Furthermore, antibiotic therapy results in recurrence rates of at least 20%. Fecal transplantation may be a feasible treatment option for recurrent C. difficile infection; moreover, it may be an early treatment option for severe C. difficile infection. We report a case of severe C. difficile infection treated with fecal transplantation using a nasoenteric tube during an initial episode. This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea.

No MeSH data available.


Related in: MedlinePlus

Serum albumin level and platelet count during treatment.HOD, hospital day.
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Figure 2: Serum albumin level and platelet count during treatment.HOD, hospital day.

Mentions: After fecal transplantation, diarrhea and ileus gradually improved and fever subsided. Platelet count, PT/aPTT and albumin level were also improved (Fig. 2). On the 84th hospital day, 9 days after fecal transplantation, laboratory test results were as follows: white blood cell count 6,280/mm3 (neutrophils, 65.3%; lymphocytes, 24.2%; monocytes, 5.3%), hemoglobin 8.1 g/dL, platelets 224,000/mm3, PT/aPTT 14.8 sec/34.4 sec and albumin 2.7 g/dL. The patient's diet was slowly advanced, and oral vancomycin was tapered to 125 mg every 12 hours. On the 94th hospital day, the patient was discharged with oral vancomycin after his symptoms had resolved. When he visited outpatient clinic 12 days after discharge, he had no symptoms of PMC; therefore, oral vancomycin was discontinued.


Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection.

Jeon YD, Hong N, Kim JH, Park SH, Kim SB, Song IJ, Ann HW, Ahn JY, Kim SB, Ku NS, Lee K, Yong D, Kim JM, Choi JY - Infect Chemother (2016)

Serum albumin level and platelet count during treatment.HOD, hospital day.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835432&req=5

Figure 2: Serum albumin level and platelet count during treatment.HOD, hospital day.
Mentions: After fecal transplantation, diarrhea and ileus gradually improved and fever subsided. Platelet count, PT/aPTT and albumin level were also improved (Fig. 2). On the 84th hospital day, 9 days after fecal transplantation, laboratory test results were as follows: white blood cell count 6,280/mm3 (neutrophils, 65.3%; lymphocytes, 24.2%; monocytes, 5.3%), hemoglobin 8.1 g/dL, platelets 224,000/mm3, PT/aPTT 14.8 sec/34.4 sec and albumin 2.7 g/dL. The patient's diet was slowly advanced, and oral vancomycin was tapered to 125 mg every 12 hours. On the 94th hospital day, the patient was discharged with oral vancomycin after his symptoms had resolved. When he visited outpatient clinic 12 days after discharge, he had no symptoms of PMC; therefore, oral vancomycin was discontinued.

Bottom Line: The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise.Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains.Furthermore, antibiotic therapy results in recurrence rates of at least 20%.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. Furthermore, antibiotic therapy results in recurrence rates of at least 20%. Fecal transplantation may be a feasible treatment option for recurrent C. difficile infection; moreover, it may be an early treatment option for severe C. difficile infection. We report a case of severe C. difficile infection treated with fecal transplantation using a nasoenteric tube during an initial episode. This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea.

No MeSH data available.


Related in: MedlinePlus