title: Fecal microbiota transplantation for fulminant Clostridium difficile infection in an allogeneic stem cell transplant patient.
abstract: We present a case of severe Clostridium difficile infection (CDI) in a non-neutropenic allogeneic hematopoietic stem cell transplant recipient who was treated successfully with fecal microbiota therapy after standard pharmacologic therapy had failed. Following naso-jejunal instillation of donor stool, the patient's symptoms resolved within 48 h. Bowel resection was averted. This is the first case in the literature, to our knowledge, to describe fecal microbiota therapy in a profoundly immunocompromised host with severe CDI. We propose that fecal microbiota therapy be considered as a therapeutic option in immunosuppressed patients with refractory severe CDI.
authors.affiliation: Infectious Diseases Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA. kneemann@unmc.edu
authors.forename: K
authors.initials: K
authors.lastname: Neemann
authors.forename: D D
authors.initials: DD
authors.lastname: Eichele
authors.forename: P W
authors.initials: PW
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Bociek
authors.forename: M
authors.initials: M
authors.lastname: Akhtari
authors.forename: A
authors.initials: A
authors.lastname: Freifeld
mesh_terms: D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology / Q000628:therapy*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007422:Intestines / Q000382:microbiology; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult