David’s case history

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Davidtm
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Joined: Mon Jun 27, 2016 10:15 pm

David’s case history

Postby Davidtm » Fri Feb 23, 2018 9:22 pm

Patient: David
Age: 35 (33 when originally diagnosed)
Sex: male
Location: California
Enthicity: white (Scottish)
Weight at diagnosis: 235 lbs
Current weight: 168
Height: 5ft 11
Allergies: peanuts and tree nuts
Dietary avoidances: coffee, alcohol, sugar(treats), dairy.

Treatments:

Metronidazole (flagyl)
Result: switched to vancomycin after 2 days

Vancomycin 125ml x4 per day for 10 days
Result: extended to 14 days
Result: failure after 32 days post medicine

Vancomycin taper:
125mlx4 per day for 14 days
125mlx2 per day for 7 days
125mlx1 per day for 7 days
125mlx1 every other day for 8 days
125mlx1 every 2 days for 8 days
Result: failure after 8 days post medicine

Vancomycin long term 3 months:
125mlx4 per day for 3 months
Result: fmt performed 2 days after completion

FMT
Result: failure at 14 days post procedure

Vancomycin long term until 2 fmt
500ml x4 per day for 8 weeks
Result: fmt performed 2 days after completion

2nd FMT
Result: successful remission for 12 months and counting.


Timeline:

April 17th 2016: diagnosed with strep throat via rapid strep test, throat pain, and visual tonsillar exudate.
- prescribed clindamycin 300mg x3 per day for 10 days
-prescribed prednisone 20mg tablet 2x daily for 5 days

April 26th 2016: strep medicines finished

May 16th 2016: gastrointestinal issues started

May 19th 2016: hallmark c-diff symptoms with
Hematochezia and increasing abdominal pain.

May 20th: urgent care visit and prescribed flagyl pending test results and based on symptoms.

May 23rd diagnosed via PCR test ordered by urgent care dr who suspected c diff based on symptoms.

July 8th 2016: relapse with all above symptoms from May 19th

August 2nd: consultation with infectious disease dr and recommendation for continued vancomycin long term

August 10th: recommendation for fmt pending vancomycin failure.

September 17th 2016: relapse with greater severity of symptoms and increased hematochezia

September 24th 2016: process started for setting up fmt pending allergist consultation. Due to my peanut and tree nut allergies there were initial concerns regarding the safety of fecal microbial transplant from a donor that is not screened for them being a part of their diet. The hospital offering the fmt procedure uses open biome as a donor source and that source said at that point in time they do not offering screening for that.

October 3rd 2016: allergist consultation believed that there was a possibility of allergic reaction and recommended either a donor of my own screening or to be hospitalized and monitored for reaction and then treated for that if necessary.

December 2016: The hospital decided to process a donor sample in house to avoid the risk of allergic reaction. My brother was screened and accepted as a suitable donor

December 15th 2016: received FMT via colonoscopy

December 27th: symptoms began returning

December 29th: relapse

Early January: received recommendation to have follow up fmt procedure after an increased dosage of vancomycin.

February 23rd 2017: received second fmt via colonoscopy which has shown to be successful

February 2017-January 2018: intermittent ibs symptoms ranging from 1 to 5 days with decreasing frequency as time goes on

March 2017 -present: alternating ibs c and d and continued weight loss due to modified diet off cutting out dairy/sweets/ and alcohol

February 2017-Present: I have reintroduced over time most of the foods I would eat before c-diff and only avoiding alcohol, dairy (have had on occasion), and treats (sweets, cake, cookies) with exception to holidays and birthdays where I have had a small amount with no effect.

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