title: Complicated fecal microbiota transplantation in a tetraplegic patient with severe Clostridium difficile infection.
abstract: A 65-year-old male suffering from acute spinal cord injury leading to incomplete tetraplegia presented with severe recurrent Clostridium difficile (C. difficile) infection subsequent to antibiotic treatment for pneumonia. After a history of ineffective antimicrobial therapies, including metronidazole, vancomycin, fidaxomicin, rifaximin and tigecycline, leading to several relapses, the patient underwent colonoscopic fecal microbiota transplantation from his healthy son. Four days subsequent to the procedure, the patient showed a systemic inflammation response syndrome. Without detecting an infectious cause, the patient received antimicrobial treatment, including tigecycline, metronidazole, vancomycin via polyethylene glycol and an additional enema for a period of seven days, leading to a prompt recovery and no reported C. difficile infection relapse during a 12 wk follow up.
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Brechmann
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Justyna
authors.initials: J
authors.lastname: Swol
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Knop-Hammad
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Willert
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Mirko
authors.initials: M
authors.lastname: Aach
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Cruciger
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Wolff
authors.initials: W
authors.lastname: Schmiegel
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Schildhauer
authors.affiliation: Thorsten Brechmann, Wolff Schmiegel, Jörg Willert, Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University Bochum, 44789 Bochum, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Hamsen
mesh_terms: D000368:Aged; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003113:Colonoscopy; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation / Q000379:methods; D005243:Feces / Q000382:microbiology; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008297:Male; D064307:Microbiota; D011782:Quadriplegia / Q000209:etiology*; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
keywords: Clostridium difficile infection; Fecal microbiota transplantation; Spinal cord injury; Systemic inflammatory response syndrome
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