Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%–30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.

Citations

Citations to this article as recorded by  

• Fecal microbiota transplantation: present and future
  Ra Ri Cha, Irene Sonu
  Clinical Endoscopy.2025; 58(3): 352.     CrossRef
• Fecal Microbiota Transplantation for Fulminant Clostridioides Difficile Infection: A Combined Medical and Surgical Case Series
  Ellen J Spartz, Mina Estafanos, Reema Mallick, Wolfganag Gaertner, Victor Vakayil, Cyrus Jahansouz, Rishav Aggarwal, Sayeed Ikramuddin, Alexander Khoruts, James V Harmon
  Cureus.2023;[Epub]     CrossRef
• Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial
  Jongbeom Shin, Jung-Hwan Lee, Soo-Hyun Park, Boram Cha, Kye Sook Kwon, Hyungkil Kim, Yong Woon Shin
  Biomedicines.2022; 10(10): 2404.     CrossRef
• The evaluation of fecal microbiota transplantation vs vancomycin in a Clostridioides difficile infection model
  Qiaomai Xu, Shumeng Zhang, Jiazheng Quan, Zhengjie Wu, Silan Gu, Yunbo Chen, Beiwen Zheng, Longxian Lv, Lanjuan Li
  Applied Microbiology and Biotechnology.2022; 106(19-20): 6689.     CrossRef
• The gut microbiota and gut disease
  Sasha R. Fehily, Chamara Basnayake, Emily K. Wright, Michael A. Kamm
  Internal Medicine Journal.2021; 51(10): 1594.     CrossRef
• RecurrentClostridium difficileInfection: Risk Factors, Treatment, and Prevention
  Jung Hoon Song, You Sun Kim
  Gut and Liver.2019; 13(1): 16.     CrossRef
• Clostridium difficile in Asia: Opportunities for One Health Management
  Deirdre A. Collins, Thomas V. Riley
  Tropical Medicine and Infectious Disease.2018; 4(1): 7.     CrossRef
• Current challenges in the treatment of severe Clostridium difficile infection: early treatment potential of fecal microbiota transplantation
  Yvette H. van Beurden, Max Nieuwdorp, Pablo J. E. J. van de Berg, Chris J. J. Mulder, Abraham Goorhuis
  Therapeutic Advances in Gastroenterology.2017; 10(4): 373.     CrossRef
• Fecal microbiota transplant in severe and severe-complicatedClostridium difficile: A promising treatment approach
  Monika Fischer, Brian Sipe, Yao-Wen Cheng, Emmalee Phelps, Nicholas Rogers, Sashidhar Sagi, Matthew Bohm, Huiping Xu, Zain Kassam
  Gut Microbes.2017; 8(3): 289.     CrossRef
• Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients
  Byoung Wook Bang, Jin-Seok Park, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, Hea Yoon Kwon, Ji Hyeon Baek, Jin-Soo Lee
  The Korean Journal of Gastroenterology.2017; 69(4): 226.     CrossRef