title: Fecal microbiota transplantation for severe clostridium difficile infection after left ventricular assist device implantation: a case control study and concise review on the local and regional therapies.
abstract: We report herein a case of fecal microbiota transplantation (FMT) used for severe Clostridium difficile infection for a 65-year-old Lebanese man who underwent left ventricular assist device implantation. To the best of our knowledge this is the first case report from Lebanon and the region presenting such technique.
  
  
  
  The patient experienced diarrhea and rectal bleeding and was diagnosed of pseudomembranous colitis (PMC). His condition failed to improve on maximal pharmacological therapy. Protocolectomy, an invasive operation consisting in resection of the entire colon and rectum seemed to be the last resort before the patient responded to FMT given through gastroscopy.
  
  
  
  Despite the increasing experience with FMT for C. difficile infection, published evidence in severe related cases from this region is very limited. Hence, we promote adjunctive FMT, an effective noninvasive method, to be considered as a promising early treatment option in severe C. difficile infection.
authors.affiliation: Gastroentorology Department, Al Rassoul Al Aazam Hospital, Beirut, Lebanon.
authors.forename: Zeina Z
authors.initials: ZZ
authors.lastname: Berro
authors.affiliation: Cardiology Department, Beirut Cardiac Institute, Beirut, Lebanon.
authors.forename: Righab H
authors.initials: RH
authors.lastname: Hamdan
authors.affiliation: Medical Research Center, Al Rassoul Al Aazam Hospital, Beirut, Lebanon.
authors.forename: Israa H
authors.initials: IH
authors.lastname: Dandache
authors.affiliation: Cardiothoracic Surgery Department, Beirut Cardiac Institute, Beirut, Lebanon.
authors.forename: Mohamad N
authors.initials: MN
authors.lastname: Saab
authors.affiliation: Medical Research Center, Al Rassoul Al Aazam Hospital, Beirut, Lebanon.
authors.forename: Hussein H
authors.initials: HH
authors.lastname: Karnib
authors.affiliation: Medical Research Center, Al Rassoul Al Aazam Hospital, Beirut, Lebanon. myouness55@yahoo.com.
authors.forename: Mahmoud H
authors.initials: MH
authors.lastname: Younes
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000254:growth & development; D003015:Clostridium Infections / Q000382:microbiology / Q000628:therapy*; D003967:Diarrhea / Q000382:microbiology / Q000628:therapy; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation; D005243:Feces / Q000382:microbiology; D006471:Gastrointestinal Hemorrhage / Q000382:microbiology / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000382:microbiology*; D006801:Humans; D007861:Lebanon; D008297:Male; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000628:therapy
keywords: Fecal microbiota transplantation3; Left ventricular assist device implantation2; Pseudomembranous colitis4; Severe Clostridium difficile1; Therapy5