Fecal Microbiota Transplantation for Recurrent Clostridium Difficile Infection in Patients with Inflammatory Bowel Disease; Case Report

Abstract

Clostridium difficile infection in patients with inflammatory bowel disease (IBD) is associated with more severe disease, longer hospital admission, higher treatment costs, higher risk of colectomy, and higher mortality rate. The classic endoscopic view of the disease is adherent whitish-yellowish multifocal membrane, defined as “psudo-membrane”. Using stool polymerase chain reaction (PCR) is the best way for identifying this organism. Patients with mild to moderate infection are treated with oral metronidazole, while severe infections are treated with oral vancomycin for 10 days. The first recurrence of clostridium infection is treated with the same regimen as the initial episode, however the second recurrence is treated with vancomycin pulse therapy. In the third recurrence, fecal microbial transplantation (FMT) is one of the treatment choices. This study is a report of three successful FMT in our patients.