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Updated: Jan 19, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Fecal microbiota transplantation as an effective initial therapy for pancreatitis complicated with severe Clostridium
Yang Hu1, Hai-Ying Xiao1, Cong He1
1Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Background:
Moderately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality. Severe Clostridium difficile infection (sCDI) is a serious and rare nosocomial diarrheal complication, especially in MSAP patients. Fecal microbiota transplantation (FMT) is a highly effective treatment for refractory and recurrent CDI (rCDI). However, knowledge regarding the initial use of FMT in patients suffering from sCDI is limited.
Case Summary:
Here, we report an MSAP patient complicated with sCDI who was treated by FMT as a first-line therapy. The patient was a 51-year-old man who suffered from diarrhea in his course of acute pancreatitis. An enzyme immunoassay was performed to detect toxins, and the result was positive for toxin-producing C. difficile and toxin B and negative for C. difficile ribotype 027. The colonoscopy revealed pseudomembranous colitis. Due to these findings, sCDI was our primary consideration. Because the patient provided informed consent for FMT treatment, we initially treated the patient by FMT rather than metronidazole. Diarrhea resolved within 5 d after FMT. The patient remained asymptomatic, and the follow-up colonoscopy performed 40 d after discharge showed a complete recovery. Our case is the first reported in China.
Conclusion:
This case explores the possibilities of initially using FMT to treat severe CDI. Moreover, FMT may become a critical component of the treatment for severe CDI in MSAP patients.
Insights
Fecal microbiota transplantation (FMT) offers a promising first-line treatment for severe Clostridium difficile infection (sCDI) in patients with moderately severe acute pancreatitis (MSAP), leading to rapid symptom resolution and recovery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiome Research
Background:
- Moderately severe acute pancreatitis (MSAP) carries high morbidity and mortality.
- Severe Clostridium difficile infection (sCDI) is a rare but serious complication in MSAP patients.
- Fecal microbiota transplantation (FMT) is effective for refractory/recurrent CDI, but its initial use in sCDI is understudied.
Purpose of the Study:
- To report the initial use of FMT in an MSAP patient with sCDI.
- To evaluate FMT as a first-line therapy for sCDI in this specific patient population.
Main Methods:
- A 51-year-old male MSAP patient with diarrhea underwent diagnostic testing.
- Diagnosis of sCDI confirmed by toxin assay and colonoscopy showing pseudomembranous colitis.
- Patient provided informed consent for FMT as first-line treatment over metronidazole.
Main Results:
- Diarrhea resolved within 5 days post-FMT.
- Patient remained asymptomatic with complete recovery confirmed by follow-up colonoscopy.
- This represents the first reported case in China.
Conclusions:
- FMT demonstrates potential as an initial treatment for severe CDI.
- FMT may be a crucial therapeutic option for sCDI in MSAP patients.
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