title: [Reccurent Clostridium difficile infection in patient after kidney transplantation on rituximab therapy due to PTLD (Post-Transplant Lymphoprolipherative Disorder). First experience with Fidaxomicin use--case report].
abstract: Clostridium difficile infection (CDI) is an increasingly problem in everyday clinical practice. The most important risk factor of this infection is antibiotics use. The incidence of Clostridium difficile associated diarrhea (CDAD) in patients after renal transplantation is estimated to be about 6% in the early postoperative period. Due to the applied immunosuppression and frequent infections requiring intensive, broad spectral antibiotics, the later prevalence of CDAD may remain at a similar level. Massive diarrhea caused by Clostridium difficile may lead to fluctuations in immunosuppressive drugs concentration, in renal transplant patients. The authors present a case study of a 23-year old patient after kidney transplantation from deceased donor, with diagnosed polymorphic PTLD (Post-Transplant Lymphoproliferative Disorder). During biological treatment with rituximab in this patient 4 recurrences of CDI were observed. In this article the clinical manifestation of recurrent CDAD are presented. The authors discuss therapeutic procedure with fidaxomicin use, its results and influence on immunosuppressive drugs concentration.
authors.forename: Dominik
authors.initials: D
authors.lastname: Cieniawski
authors.forename: Ewa
authors.initials: E
authors.lastname: Ignacak
authors.forename: Alina
authors.initials: A
authors.lastname: Bętkowska-Prokop
authors.forename: Barbara
authors.initials: B
authors.lastname: Dudzik
authors.forename: Bogusław
authors.initials: B
authors.lastname: Walatek
authors.forename: Marek
authors.initials: M
authors.lastname: Kuźniewski
authors.forename: Władysław
authors.initials: W
authors.lastname: Sułowicz
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D016360:Clostridioides difficile; D003967:Diarrhea / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000382:microbiology*; D000077732:Fidaxomicin; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D012008:Recurrence; D000069283:Rituximab; D055815:Young Adult
chemical_list: D000617:Aminoglycosides; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D000077732:Fidaxomicin