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Pediatric severe pseudomembranous enteritis treated with fecal microbiota transplantation in a 13-month-old infant

机译:粪便菌群移植治疗小儿重症伪膜性肠炎13个月大婴儿

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摘要

Fecal microbiota transplantation (FMT) is a procedure used to restore the intestinal microbiota of a diseased individual using indigenous intestinal microorganisms from a healthy donor. The current case report presents the first case of a 13-month-old male with severe pseudomembranous enteritis (PME) treated with FMT. The infant was admitted to Shanghai Children's Hospital with a 2-month history of diarrhea, and a 1.5-month history of retractable edema, hypoalbuminemia, electrolyte disturbance and malnutrition. Besides necessary nutritional support, the patient was treated twice with oral metronidazole combined with or without vancomycin. Diarrhea was partially remitted. However, the infant had bloody or dark-green feces, and a distended abdomen. On day 96 from the initiation of the disease, a single FMT via a nasal jejuna feeding tube was performed. From day 2 until 4 months post-FMT, the patient presented with no diarrhea, normal feces and a satisfactory weight. To the best of our knowledge, this is the first pediatric PME treated with FMT. The current data show that FMT is an efficient choice for recurrent clostridium difficile infection and PME in adults and a few pediatric cases. Due to a lack of safety and effectiveness data, treatment should be cautiously applied in the pediatric population.
机译:粪便微生物群移植(FMT)是一种使用来自健康供体的本地肠道微生物恢复患病个体肠道菌群的程序。本病例报告介绍了首例13个月大的男性,经FMT治疗后患有严重的假膜性肠炎(PME)。该婴儿入院上海儿童医院,腹泻病史为2个月,水肿,低白蛋白血症,电解质紊乱和营养不良为1.5个月病史。除了必要的营养支持外,该患者接受口服甲硝唑联合或不联合万古霉素治疗两次。腹泻得到部分缓解。但是,该婴儿有血腥或深绿色的粪便,腹部膨大。从疾病开始的第96天,通过空肠鼻饲管进行单次FMT。从FMT后第2天到4个月,患者无腹泻,粪便正常且体重令人满意。据我们所知,这是第一款采用FMT治疗的儿科PME。目前的数据表明,FMT是成人和少数儿科患者复发性艰难梭菌感染和PME的有效选择。由于缺乏安全性和有效性的数据,应谨慎地在儿科人群中进行治疗。

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