Clostridium difficile cure with fecal microbiota transplantation in a child with Pompe disease

A case report

D. E. Dow*, Patrick Casey Seed

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitalization and the emergence of strains of Clostridium difficile that are hypervirulent and associated with high rates of relapse. Case presentation: This case describes a medically complex 21-month-old Hispanic girl with Pompe disease and B cell immunodeficiency with recurrent Clostridium difficile infection refractory to antimicrobial management. She presented with nine recurrent episodes of Clostridium difficile infection including fever, foul smelling diarrhea, and respiratory distress with failed sustained responses to compliant treatment using metronidazole and pulsed vancomycin therapy. Maternal donor fecal microbiota transplantation was performed with complete symptom resolution and produced a sustained cure, now 5 years in duration. Conclusions: This patient presented with symptomatic Clostridium difficile at an early age causing significant morbidity and reduced quality of life. After nearly one year of failed medical management, fecal microbiota transplantation provided a cure. Further evidence-based research is necessary to test the safety and efficacy of this low technology, low cost, and morbidity-sparing therapy in children.

Original languageEnglish (US)
Article number112
JournalJournal of Medical Case Reports
Volume12
Issue number1
DOIs
StatePublished - Apr 28 2018

Fingerprint

Glycogen Storage Disease Type II
Clostridium difficile
Clostridium Infections
Morbidity
Metronidazole
Vancomycin
Hispanic Americans
Diarrhea
Hospitalization
B-Lymphocytes
Fever
Therapeutics
Mothers
Quality of Life
Fecal Microbiota Transplantation
Tissue Donors
Anti-Bacterial Agents
Technology
Safety
Costs and Cost Analysis

Keywords

  • Fecal microbiota transplantation
  • Medically complex children
  • Refractory Clostridium difficile

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{fe1033b1de4843d8979228df66e9cf4a,
title = "Clostridium difficile cure with fecal microbiota transplantation in a child with Pompe disease: A case report",
abstract = "Background: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitalization and the emergence of strains of Clostridium difficile that are hypervirulent and associated with high rates of relapse. Case presentation: This case describes a medically complex 21-month-old Hispanic girl with Pompe disease and B cell immunodeficiency with recurrent Clostridium difficile infection refractory to antimicrobial management. She presented with nine recurrent episodes of Clostridium difficile infection including fever, foul smelling diarrhea, and respiratory distress with failed sustained responses to compliant treatment using metronidazole and pulsed vancomycin therapy. Maternal donor fecal microbiota transplantation was performed with complete symptom resolution and produced a sustained cure, now 5 years in duration. Conclusions: This patient presented with symptomatic Clostridium difficile at an early age causing significant morbidity and reduced quality of life. After nearly one year of failed medical management, fecal microbiota transplantation provided a cure. Further evidence-based research is necessary to test the safety and efficacy of this low technology, low cost, and morbidity-sparing therapy in children.",
keywords = "Fecal microbiota transplantation, Medically complex children, Refractory Clostridium difficile",
author = "Dow, {D. E.} and Seed, {Patrick Casey}",
year = "2018",
month = "4",
day = "28",
doi = "10.1186/s13256-018-1659-2",
language = "English (US)",
volume = "12",
journal = "Journal of Medical Case Reports",
issn = "1752-1947",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Clostridium difficile cure with fecal microbiota transplantation in a child with Pompe disease

T2 - A case report

AU - Dow, D. E.

AU - Seed, Patrick Casey

PY - 2018/4/28

Y1 - 2018/4/28

N2 - Background: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitalization and the emergence of strains of Clostridium difficile that are hypervirulent and associated with high rates of relapse. Case presentation: This case describes a medically complex 21-month-old Hispanic girl with Pompe disease and B cell immunodeficiency with recurrent Clostridium difficile infection refractory to antimicrobial management. She presented with nine recurrent episodes of Clostridium difficile infection including fever, foul smelling diarrhea, and respiratory distress with failed sustained responses to compliant treatment using metronidazole and pulsed vancomycin therapy. Maternal donor fecal microbiota transplantation was performed with complete symptom resolution and produced a sustained cure, now 5 years in duration. Conclusions: This patient presented with symptomatic Clostridium difficile at an early age causing significant morbidity and reduced quality of life. After nearly one year of failed medical management, fecal microbiota transplantation provided a cure. Further evidence-based research is necessary to test the safety and efficacy of this low technology, low cost, and morbidity-sparing therapy in children.

AB - Background: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitalization and the emergence of strains of Clostridium difficile that are hypervirulent and associated with high rates of relapse. Case presentation: This case describes a medically complex 21-month-old Hispanic girl with Pompe disease and B cell immunodeficiency with recurrent Clostridium difficile infection refractory to antimicrobial management. She presented with nine recurrent episodes of Clostridium difficile infection including fever, foul smelling diarrhea, and respiratory distress with failed sustained responses to compliant treatment using metronidazole and pulsed vancomycin therapy. Maternal donor fecal microbiota transplantation was performed with complete symptom resolution and produced a sustained cure, now 5 years in duration. Conclusions: This patient presented with symptomatic Clostridium difficile at an early age causing significant morbidity and reduced quality of life. After nearly one year of failed medical management, fecal microbiota transplantation provided a cure. Further evidence-based research is necessary to test the safety and efficacy of this low technology, low cost, and morbidity-sparing therapy in children.

KW - Fecal microbiota transplantation

KW - Medically complex children

KW - Refractory Clostridium difficile

UR - http://www.scopus.com/inward/record.url?scp=85046171878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046171878&partnerID=8YFLogxK

U2 - 10.1186/s13256-018-1659-2

DO - 10.1186/s13256-018-1659-2

M3 - Article

VL - 12

JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

IS - 1

M1 - 112

ER -