Clostridioides difficile infection (CDI) is becoming more common in the United States. After initial therapy, approximately 10–20 percent relapse, with increasing recurrence following repeated treatment cycles. This sequence can result in recurrent CDI (rCDI), which is resistant to standard therapies and is the most prevalent rationale for faecal microbiota transplantation (FMT). FMT is the most successful microbiological therapy available to date, curing rCDI in 80–90% of cases. However, there is rising worry about disease transmission by FMT, emphasising the significance of cautious recipient screening.

Alternative diagnoses were recognised in 25% of adults referred for FMT with a provisional diagnosis of rCDI, but equivalent observation in children is missing. Alternative diagnoses (eg, constipation/overflow diarrhoea, inflammatory bowel disease) were discovered in 13 (22.4 percent) of 58 children referred for FMT examination for rCDI in this single-center retrospective analysis. FMT was not required in 16 (27.6 percent) of the patients identified with rCDI.

Reference: https://journals.lww.com/jpgn/Abstract/2021/05000/Alternative_Diagnoses_in_Pediatric_Fecal.12.aspx