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

• Published in: BMC infectious diseases Vol. 16; no. 229; p. 234
• Main Authors: Berro, Zeina Z, Hamdan, Righab H, Dandache, Israa H, Saab, Mohamad N, Karnib, Hussein H, Younes, Mahmoud H
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.05.2016; BioMed Central
• Subjects: Aged; Antibiotics; Antigens; Antimicrobial agents; Care and treatment; Case Report; Case-Control Studies; Clostridium difficile - growth & development; Clostridium infections; Clostridium Infections - microbiology; Clostridium Infections - therapy; Complications and side effects; Consent; Diarrhea; Diarrhea - microbiology; Diarrhea - therapy; Enterocolitis, Pseudomembranous - microbiology; Enterocolitis, Pseudomembranous - therapy; FDA approval; Fecal Microbiota Transplantation; Feces - microbiology; Funding; Gastrointestinal Hemorrhage - microbiology; Gastrointestinal Hemorrhage - therapy; Heart attacks; Heart-Assist Devices - adverse effects; Heart-Assist Devices - microbiology; Hospitals; Humans; Infections; Infectious diseases; Inflammation; Inflammatory bowel disease; Intensive care; Lebanon; Male; Mortality; Prosthesis Implantation - adverse effects; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - therapy; Risk factors; Studies; Surgery; Tomography; Veins & arteries; Lebanon; Fecal microbiota transplantation3; Severe Clostridium difficile1; Therapy5; Pseudomembranous colitis4; Left ventricular assist device implantation2
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-016-1571-6

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.