RESUMO
A 61-year-old male patient being treated with intravenous antibiotics for left foot osteomyelitis presented to the hospital septic, with several days of worsening abdominal pain, bloating and watery bowel movements. Investigation revealed that the patient had severe, treatment-resistant Clostridioides difficile colitis. He was initially treated with oral vancomycin and intravenous metronidazole, which was switched to oral fidaxomicin. After no improvement in the patient's symptoms, he was treated with two faecal microbiota transplants. He was offered a third faecal microbiota transplant but declined. The patient was placed back on oral fidaxomicin and saw ultimate resolution of his symptoms. This case provides an example of a treatment pathway for refractory C. difficile infection.
Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Infecções por Clostridium/terapia , Colite/microbiologia , Colite/terapia , Transplante de Microbiota Fecal , Osteomielite/tratamento farmacológico , Administração Intravenosa , Terapia Combinada , Farmacorresistência Bacteriana Múltipla , Fidaxomicina/uso terapêutico , Pé/cirurgia , Humanos , Masculino , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Vancomicina/uso terapêuticoRESUMO
This report describes the model of specialty clinics implemented at Stanford University's two student-run free clinics, Arbor Free Clinic and Pacific Free Clinic, in the San Francisco Bay Area. We describe our patient demographic characteristics and the specialty services provided. We discuss challenges in implementing specialty care at student-run free clinics.
