scholarly journals Too Early to Recommend Early Fecal Microbiota Transplantation in Patients With Severe Clostridium difficile Infection, or Not Too Early?

2017 ◽  
Vol 66 (5) ◽  
pp. 651-652 ◽  
Author(s):  
Antoine Andremont
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Severe Clostridium Difficile Infection

scholarly journals Routine Treatment-Resistant Clostridium difficile Infection during Recovery from Myxedema

2017 ◽  
Vol 11 (3) ◽  
pp. 748-754 ◽  
Author(s):  
Jan K. Adamski ◽  
Björn B. Jäschke ◽  
Raija S. Uusitalo-Seppälä ◽  
Kalle V.J. Moilanen ◽  
Antti V. Pehkonen ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Laboratory Tests ◽  
Fecal Microbiota Transplantation ◽  
Recovery Phase ◽  
Fecal Microbiota ◽  
Treatment Resistant ◽  
Clinical Recovery ◽  
Resistant Form ◽  
Severe Clostridium Difficile Infection

Development of the extreme form of hypothyroidism defined as myxedema is very rare. Acute symptoms and their management have been described in detail previously. However, not much attention has been devoted to therapeutic challenges that are faced in the recovery phase of the treatment, especially pertaining to the gastrointestinal system. The link between myxedema and the appearance of severe Clostridium difficile infection (CDI) has not been established so far. A 61-year-old woman with no significant medical record was admitted to hospital because of infected heel pressure and thyroid dysfunction. A week later, due to hypothermia, hypotension, and unconsciousness, she was transferred to the intensive care unit. The clinical picture and the results of laboratory tests confirmed diagnosis of myxedema. After the introduction of resuscitative measures and hormonal substitution, patient’s condition stabilized within 10 days. Due to concomitant sepsis, initially piperacillin/tazobactam and later cefuroxime were administered. After 20 days of antibiotic therapy, the patient developed CDI that was resistant to the routine mode of treatment. The clinical recovery was achieved only after a fecal microbiota transplantation procedure. The function of the digestive tract in myxedema is disturbed by gastric achlorydia and reduced peristalsis, which in turn can predispose the small intestine to overgrowth of bacteria. The use of antibiotics can additionally decrease the intestinal bacterial diversity, favoring the overgrowth of Clostridium difficile. The authors conclude that myxedema may increase the likelihood of a treatment-resistant form of CDI that requires the implementation of fecal microbiota transplantation.

scholarly journals Patient Perspectives on Fecal Microbiota Transplantation for Clostridium Difficile Infection

2016 ◽  
Vol 5 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Caroline Zellmer ◽  
Travis J. De Wolfe ◽  
Sarah Van Hoof ◽  
Rebekah Blakney ◽  
Nasia Safdar
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Patient Perspectives
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