Discordance in Clinical Indicators With Sequential Fecal Microbiota Transplantation: A Case of Fulminant Clostridioides Difficile Infection

TL;DR

This case study shows that C-reactive protein is a key marker for tracking recovery in severe C. difficile infection after fecal microbiota transplantation.

Contribution

The study highlights the importance of C-reactive protein as a reliable biomarker for assessing residual colitis in CDI treatment.

Findings

Clinical indicators like stool frequency and pseudomembrane resolution showed discordance in treatment response.

C-reactive protein levels were found to be a more accurate marker for residual colitis and disease resolution.

Incorporating C-reactive protein into scoring systems could improve CDI management.

Abstract

Fulminant Clostridioides difficile infection (CDI) is a rare, severe type of CDI, often associated with extended hospitalizations, significant healthcare costs, and elevated mortality rates. Fecal microbiota transplantation remains an effective treatment modality for patients with fulminant CDI, with high cure rates reported after multiple treatments. Stool frequency, pseudomembrane resolution, and inflammatory markers are routinely monitored to evaluate disease severity and treatment responsiveness. Our case highlights a discordance in these indicators and demonstrates C-reactive protein as an important marker in assessing residual colitis and disease resolution. Comprehensive scoring systems should consider incorporating C-reactive protein and other biomarkers to optimize CDI management.

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