Hi: New Member here

[andy2007]

Hi everyone
First, thanks for allowing me to join the group. I have read through the guidelines and some of the posts. It seems like there is a lot of great info here and friendly people.
My name is Andy. I am male, 45, and from the UK, although I have lived in Taiwan for over a decade and have a wife and family here. My story is a little bit complicated, but I will try and make it as clear as possible.
On December 13th 2019 I visited the emergency department of a local hospital as I was feeling terrible with a high fever and diarrhea for two days. My blood results showed a very high crp score (210 mg/l) and my platelets had dropped. WBCs were within normal range, but a stool check showed leukocytes in stool. I ended up staying for five days and was given a 5-day course of ceftriaxone (3rd gen cephalasporin). The doctor could not find out the cause of the bacterial infection despite checking a whole range of possible causes. They just termed it 'infectious colitis' and I don't believe I was checked for C.diff at that time.
I started feeling better after a day on the medication and diarrhea improved. After I got home, I was on a low fodmap diet and was just about back to normal after two weeks. Then on Dec 27th I started to get a lot of mucus in my stool and on the following day some blood. I thought the amount of blood was significant and it really worried me so I went back to the hospital again thinking the infection had returned. (It is also possible that the blood was from hemorrhoids, although I'd never experienced that much before).
This hospital check revealed a near normal CRP, normal WBCs, but again showed leukocytes in the stool sample. I had no fever or abdominal pain and felt mostly alright. This time, tests were taken again and I was admitted. They again put me on ceftriaxone and also metronidazole in case the results showed c.diff. As the doctor was concerned, they did a colonoscopy and this revealed some mild inflammation. They weren't sure if it was from an infection or IBD. The following day, the results confirmed c.diff. The ceftriaxone was stopped, and because I had developed a mild rash after metronidazole they switched me to Vancomycin (125g, 4 times a day).
So, after three days in the hospital I have returned home with the medication. I have an appointment in a week to check progress. At the moment I am eating a simple diet and feel okay. Today is my fourth day on Vancomycin. Yesterday I only had one bowel movement and while this was not fully formed it wasn't that watery. Today my stool is slightly formed. I have read up on the condition, but would really appreciate any help or suggestions that anyone could give.

*One thing that confused me is the blood in stool. Almost all of the literature says that this is associated with severe cases. As my WBCs were normal and I had no pain or fever, or pseudomembranes visible on colonoscopy, I'm wondering how that happened. Can people have bloody stools in mild cases, too?
*I have also been confused about the first time I was admitted to hospital and wonder whether that could also have been c.diff. I guess it would be strange though as the infection cleared up with ceftriaxone. My thinking is that the antibiotics from the first time wiped out my good gut bacteria and I picked up an infection in the hospital. Does this sound likely?

I have tried to read up on everything I can on c.diff in Taiwan. It seems like it is nowhere near as common as in the US or the UK. The doctor told me that they have 90% success rates with treatment here and low recurrences, but it is difficult to verify this. I'm not sure if that is because of different strains, but I have read that the 027 strain is not really prevalent here.
At the moment I feel quite worried and am terrified of passing it on to my family. I am sleeping separately from my wife for a few days and her and the kids are using a separate bathroom. I have also cleaned the rooms and surfaces with bleach. We will also wash clothes separately.

*Can anyone tell me how likely it could be for them to pick up this infection from spores in the house? I am going out of my mind with worry. We are all washing hands carefully, but with eleven-year-old twins it is not always easy to make sure that fingers are kept out of mouths etc. My wife and kids are all healthy and have had no recent courses of antibiotics.

*I'd also like to know about cure and recurrence rates although I can probably find that information on this site after a bit more checking. I think Taiwan is similar to the states with regards to treatment. FMT is also available here, but it is not as widely used as in North America. Hopefully I could do this if other options failed. My final question is related to this. Does anyone know if FMT would work across different races of people? I know I might be thinking too far ahead, but I was wondering how it works with donors. Can stools from Asian donors be used on Caucasian people such as myself. I wasn't sure if the difference in genetic makeup had any part to play in that. I know that is a tough questions, but any help would be appreciated.
Sorry for the lengthy introduction and questions. I am just looking for a few answers as I am confused and anxious. Please accept my apologies if this has been posted in the wrong place. Any responses would be greatly appreciated.
Kind regards and hi to everyone.

Andy

[NanciT]

Hello Andy and Welcome to the site You mentioned you have read the first thread for all new posters

We cannot diagnose so I won't remark on your initial hospital visit but the 2nd time you did come up CDIFF positive with diarrhea. The Vanco sounds like it is working and hopefully when you complete the treatment you will be recovering. It sound like you have a follow up which is great, stick to your light diet as the gut recovers.
It's possible you picked it up in the hospital during the first visit but it's hard to know. As far as number of cases in Taiwan, we really can't know. I have found through my years of experience in medicine in the US, CDIFF numbers are under reported here.

While CDIFF active, if you can stick to your won bathroom at home that is helpful. Use beach to clean it and proper handwashing during this time.

Hopefully you will continue to improve and move past this

Take Care

NanciT

[beth22]

I don't know your answer about the different races, but there is a company called OpenBiome that provides donor stool to hospitals and doctors who do FMT. I don't think they match up by race, but that might be a good question to ask them. You could try to send an e-mail and see if you get an answer. The only thing I have heard is that blood relatives are sometimes better and cause less PI-IBS after FMT. That was the case with me. My husband was my first donor and I had very bad IBS afterwards. In fact, I had SIBO. When I used my daughter, this was not the case.

No one in my family got c diff from me and my husband used the same bathroom. At work, we all shared a small bathroom - about 7 or 8 of us and no one got sick either. I would definitely continue with the good hand hygiene and since you have children, best to have them use a different bathroom.

[andy2007]

Thanks for the kind replies guys.
The info about cleaning was helpful. I'm still not sure when it is best for my wife to share the same bedroom though. I'm concerned about bed sheets/spores etc.

Beth 22. I note that you said your daughter was an FMT donor for you. I am just looking at all possible treatments for the future, but at this stage don't know if that will apply to me. I also have a daughter, and a son, however they are only eleven. Do you know if children that age can be donors to parents if ever required?

Andrew

[beth22]

Children that age are not good candidates from what I have read. I know someone who used her 14 year old son and had a successful FMT, but usually at least 16 is preferred. My daughter is an adult.

[AllisS]

The spores are always present in the environment, but unless someone is susceptible, often due to having been taking a wide-spectrum antibiotic, they don't generally cause infection. There's no compelling reason to avoid sharing a bedroom. As Beth said, C. diff seldom is transmitted to family members. The best prevention is to make a habit of washing hands thoroughly with soap and water before eating or preparing food and after bathroom use -- and to encourage your family members to practice this routine as well. It's also a good idea to wash hands after returning home from outside errands or activities.

[andy2007]

Thanks for the info.
This might be a silly question, but I was wondering about response rates to meds. I have read that 1 in 4 or 5 have a recurrence. Does this mean that the meds worked, but then the person had a recurrence after, or does it mean that the meds don't work 20 to 25 percent of the time?
I'm wondering as I have been on vancomycin for four days now. Don't have diarrhoea and stools seem to be becoming more formed and less ragged. I'm taking that as the medicine working at the moment.

Andrew

[NanciT]

Hi Andy

I don't have the actual response rates, the information on the net can vary. It sounds like you are doing well on Vanco, hopefully you will finish the round and find you are slowly getting better. Some improve faster than others.
I myself feel there are several strains out there and I had a difficult one. I was fine on the treatment and did not relapse until weeks latter. Some strains are tougher to treat and I am convinced I had a very difficult strain.

This illness can cause a great deal of anxiety, if you can focus on getting through the vanco, stick with a bland diet for awhile and push through. We have MANY on the site that take one round and move on, we don't hear from them again.

Hang in there, you will get there

NanciT

[roy]

All the meds including flagyl have equal c.diff killing power.
99.9% of the time the symptoms resolve and a clinical cure is achieved but that's only half of the "final cure"
The problems arise when the meds are finished because its then a race between c.diff and the good flora to regrow and fill the space created by the meds.
If the good flora regrows fastest it kicks out any remaining spores and the "cure" is complete.
Flagyl is broad spectrum and kills a LOT of the good flora, Vanco is less destructive so kills less and dificid is supposed to kill only c.diff.
Each are equal at killing c.diff but in turn are inferior because of the collateral damage that delays the return of the good flora thats needed to finish the cure.

[andy2007]

Thanks Roy. That was helpful.
I also had another question that I hope someone could help me with.
Today I had a follow-up with the doctor to check progress on meds etc. I noticed that my stool check report from when I went to hospital said GDH positive, toxin negative. I am a bit confused by this but after a bit of research it seems like it's a common finding. If toxin is negative, does that mean that it is a less serious strain of c.diff? I was asking the doctor if I definitely had c diff but he could only say that he thinks I likely have it. I'm not sure what to do now. I have read of a PCR test which is more accurate. I'm wondering if that should have been done at the time.
Can anyone give me any advice?

Andrew

[roy]

That result is a negative!
Theres many types of c.diff and half are 100% harmless but they are all picked up by GDH (and pcr) GDH is followed by a toxin test to identify if the strain you have needs treating.
If theres no toxins there is no disease.
Your symptoms do indicate colitis though.

[beth22]

I tested like that for over 2 years and was told it was negative. I needed no treatment.

[andy2007]

It just leaves me more confused.
I am on day seven of vancomycin and am almost back to normal so whatever it was has responded to that. I had diarrhea and mucus (green color) horrible smell and a scope that showed some inflammation in colon. Also had blood in stool when I first went to the hospital, however all blood checks were normal apart from leukocytes in stool.
It seems like these are the symptoms of c diff.
I have done more reading and it says that if GDH is positive and toxin is negative then it should proceed to a PCR test as it is indeterminate. I am not sure if I had this follow up test on my sample. I will ask at my next appointment. Maybe in the states going straight to the PCR test is part of the protocol.

Andy

Andrew

[AllisS]

Thanks, Roy, for the excellent explanation about the difference between Flagyl vs. Vanco vs. Dificid. I've always been unclear about this.

[andy2007]

Did anyone find that they lost weight with c.diff? I have lost about 6 kg in the last month. I feel like I am eating very healthily and cut out everything fatty and oily and am following a low fodmap diet. I'm still eating a lot but not seeing much weight gain. Hope it doesn't take too long to put some back on. If I do a month of no beer I always lose a lot of weight, but I'm still thinner than I expected this time. Maybe it is to be expected as I had at least a week last month of eating very little.
Does anyone have any ideas for healthy weight gain? I'm actually within normal range - 182cm and 76 kg, but I'm quite concerned as everyone keeps telling me how much weight I have lost.

Andy