1. Institute of General Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia
2. Yu.E Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow 125412, Russia

Keywords: CDI, clostridial infection, fecal microbiota transplantation, diarrhea

Abstract:In recent decades, against the background of widespread and, often, unfounded antibiotic therapy, an increase in Clostridium diffi cile infection (CDI) due to hypervirulent strains has been observed. According to international CDI treatment protocols, metronidazole and vancomycin are starting therapy for patients with newly diagnosed infections, even though the likelihood of a relapse is about 65%. In addition, the increased interest in CDI is associated with the need to develop and use alternative strategies aimed at preventing and increasing the eff ectiveness of treatment. In this regard, we fi rst transplanted fecal microfl ora for this group of patients in Russia. This alternative method of treatment removes the spores of C. diffi cile, replenishes the normal intestinal fl ora, reduces the level of vegetative forms of C. diffi cile in the intestines, and supports the patient’s own immune response.

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Full text is published :
Schreiner E. B., Morozov V. V., Khavkin A. I., Vlasov V. V., Kulikov V. D., Koltsova S. T. The experience of the fecal microbiota transplantation in a patient with clostridial infection. Experimental and Clinical Gastroenterology. 2018;160(12): 80–83. (In Russ.) DOI: 10.31146/1682-8658-ecg-160-12-80-83
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1. Federal state budgetary institution of higher education “Novosibirsk State Medical University” of the Russian Ministry of Health, Novosibirsk, Russia

Keywords: staphylococcal endocarditis, gastrointestinal debut

Abstract:Staphylococci are now the most common cause of infective endocarditis (IE). The onset of staphylococcal endocarditis (SE) is acute, with high fever, severe intoxication, and therefore, during the initial visit to the doctor, there is an erroneous assumption of infl uenza, meningitis, hepatitis and other acute diseases. Sometimes the cause of the development of SE remains unclear, the initial clinical manifestations are characterized by high activity of the process, severe general condition of patients, hectic fever, stunning chills, sweats, yellow staining of the skin and mucous membranes, vomiting with blood, leukocytosis, anemia. A clinical case of gastrointestinal SE debut is described with signs of hepatitis and gastric ulcer. Hemorrhages and necrosis of the mucous membrane led to the formation of erosions and ulcers in the antrum and pyloric regions of the stomach, which was manifested by the sudden appearance of severe pain in the abdomen, vomiting with blood. Gastrointestinal manifestations of necrotic vasculitis at the beginning of the SE complicated its timely diagnosis. Hemorrhagic rash was characterized by extensive lesions with the transition to necrosis or suppuration. Cerebral embolism led to multiple brain abscesses, the symptoms of which became leading in the clinical picture. Coronary emboli caused the formation of myocardial abscesses. The use of a chemotherapeutic combination of vancomycin, amikacin and rifampicin with a highly virulent pathogen was ineff ective: signs of severe heart damage with perforation of the coronary valve of the aortic valve developed. Progressive multi-organ failure has been fatal.

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Full text is published :
Drobysheva V. P., Demin A. A., Osipenko M. F. Gastrointestinal debut of acute staphylococcal endocarditis. Experimental and Clinical Gastroenterology. 2018;160(12): 84–86. (In Russ.) DOI: 10.31146/1682-8658-ecg-160-12-84-86
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