Background: Patients with malignant diseases are at high risk for refractory Clostridioides difficile infections (CDI). Fecal microbiota transplantation (FMT) restores the gastrointestinal microbiome and may be an effective treatment for patients who fail pharmacotherapy. However, FMT is not commonly used in the oncology population because of risk for donor-derived infection. Observations: The authors report successful use of FMT in a pediatric patient with refractory CDI actively receiving chemotherapy. The patient’s symptoms improved 1 day following FMT. He did not experience infectious complications or other adverse effects. Conclusions: FMT may be a feasible option for treatment of refractory CDI in pediatric oncology patients.

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