Successful therapy of severe pseudomembranous clostridium difficile colitis using a combination of fecal microbiota therapy and fidaxomicin

Objective: The aim of this work was to describe the use of a combination of fidaxomicin and fecal microbiota therapy [FMT] in Clostridium difficile infection [CDI]

Clinical Presentation and Intervention: A 78-year-old female, who was admitted for surgery due to acute diverticulitis caused by postoperative complications and broad antibiotic therapy, developed CDI-induced colitis. Despite the introduction of metronidazole and vancomycin therapy, her clinical condition continued to deteriorate. She was transferred to the intensive care unit where FMT followed by fidaxomicin were performed because her C-reactive protein and leucocyte levels remained elevated. Further clinical improvement and the resolution of colitis was observed

Conclusion: In this case, severe CDI colitis was successfully treated with the combination of FMT and fidaxomicin

Hypertrophic pachymeningitis and the syndrome of inappropriate antidiuretic hormone secretion: coincidence or cause?

Objective: To investigate a potential cause of the syndrome of inappropriate antidiuretic hormone secretion [SIADH]

Clinical Presentation and Intervention: A 70-year-old female patient had nausea and collapsed. Although euvolemic, pathological laboratory findings showed hyponatremia and hypoosmolality, and cerebral magnetic resonance imaging showed hypertrophic pachymeningitis. Secondary hyper-trophic pachymeningitis was excluded. Other nonneurolog-ical reasons for SIADH were also excluded. Moderate fluid restriction restored an almost normal serum osmolality and sodium

Conclusion: This case of SIADH was conservatively treated with moderate fluid restriction that almost restored normal serum osmolality and sodium levels