Transient Flare of Ulcerative Colitis After Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection

• Published in: Clinical gastroenterology and hepatology Vol. 11; no. 8; pp. 1036 - 1038
• Main Authors: De Leon, Lauren M, Watson, James B, Kelly, Colleen R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2013
• Subjects: Adverse Event; Aged; Biological Therapy - adverse effects; Biological Therapy - methods; Clostridium difficile - isolation & purification; Clostridium Infections - therapy; Colitis, Ulcerative - pathology; Gastroenterology and Hepatology; Humans; IBD; Male; Risk; Side Effect; Side Effect; Risk; CDI; IBD; ulcerative colitis; FMT; Adverse Event; Clostridium difficile infection; fecal microbiota transplantation; inflammatory bowel disease; UC
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2013.04.045

Clostridium difficile infection (CDI) is a common cause of infectious diarrhea and is usually treated with metronidazole or vancomycin. CDI recurs in 15%–30% of patients after the initial episode and in up to 65% after a second episode. Recurrent infections are a challenge to treat, and patients are usually managed with prolonged pulsed or tapered vancomycin. Fecal microbiota transplantation is an alternative treatment that has a 91% rate of success worldwide, with no reported complications. We describe a patient with ulcerative colitis that had been quiescent for more than 20 years who developed a flare of ulcerative colitis after fecal microbiota transplantation, indicating the need for caution in treating CDI with fecal microbiota transplantation in patients with inflammatory bowel disease.