Fecal transplant for recurrent Clostridium difficile infection

Clostridium difficile infection (CDI) results in clinical manifestations ranging from mild diarrhea to life-threatening pseudomembranous colitis. Infection is most often initiated by antimicrobial therapy which causes an imbalance in normal colonic microflora. The pathogenesis of C. difficile is predominantly controlled by the production of its two cytotoxins, A and B, which damage the intestinal mucosa. In recent years a nationwide increase in the rate of CDI has been noted as well as an increase in mortality, reduced initial response to antimicrobials, extended resolution time, and increased rates of recurrence. Traditional treatment includes administration of antimicrobials. Fecal microbiota transplant (FMT) is an alternative therapy for CDI that is effective and promising in multiple CDI relapse patients. This paper will provide an overview of CDI epidemiology, pathogenesis, diagnosis, and treatment, and explore the case of a 53-year-old woman suffering from her sixth episode of CDI.