A Report of Fecal Transplantation for Refractory Clostridium Difficile Colitis in an Orthotopic Liver Transplant Recipient

A 61 year old woman received an orthotopic liver transplant for nonalcoholic steatohepatitis. Two months after her transplant she developed diarrhea that was found to be caused by Clostridium Difficile. Her colitis was refractory to antibiotic therapy. Fecal transplantation was used via a nasojejunal route with immediate clinical improvement. She redeveloped symptoms and Clostridium toxin positivity weeks later after broad spectrum antibiotics were given for presumed pneumonia. This colitis was refractory to another round of antibiotics, and a second fecal transplant was performed with similarly positive results.