title: Transient flare of ulcerative colitis after fecal microbiota transplantation for recurrent Clostridium difficile infection.
abstract: Clostridium difficile infection (CDI) is a common cause of infectious diarrhea and is usually treated with metronidazole or vancomycin. CDI recurs in 15%-30% of patients after the initial episode and in up to 65% after a second episode. Recurrent infections are a challenge to treat, and patients are usually managed with prolonged pulsed or tapered vancomycin. Fecal microbiota transplantation is an alternative treatment that has a 91% rate of success worldwide, with no reported complications. We describe a patient with ulcerative colitis that had been quiescent for more than 20 years who developed a flare of ulcerative colitis after fecal microbiota transplantation, indicating the need for caution in treating CDI with fecal microbiota transplantation in patients with inflammatory bowel disease.
authors.affiliation: Rhode Island Hospital, Brown University Alpert School of Medicine, Providence, Rhode Island, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: De Leon
authors.forename: James B
authors.initials: JB
authors.lastname: Watson
authors.forename: Colleen R
authors.initials: CR
authors.lastname: Kelly
mesh_terms: D000368:Aged; D001691:Biological Therapy / Q000009:adverse effects* / Q000379:methods*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000628:therapy*; D003093:Colitis, Ulcerative / Q000473:pathology*; D006801:Humans; D008297:Male
keywords: Adverse Event; CDI; Clostridium difficile infection; FMT; IBD; Risk; Side Effect; UC; fecal microbiota transplantation; inflammatory bowel disease; ulcerative colitis