A Case of Clostridium septicum Aortitis With Concomitant Adenocarcinoma of the Cecum

Abstract

Introduction:Clostridium septicum aortitis (C. septicum aortitis)is an exceedingly rare infection that is strongly associated with underlying adenocarcinoma of the colon. Currently, there are less than 30 cases of C. septicum aortitis that have been reported in the English literature. We report a case of a 73-year-old female with peripheral vascular disease who presented with 4 weeks of severe abdominal pain. Abdominal computed tomography showed, in addition to thickening of the cecal wall, gas in the aortic wall. Colonoscopy performed the following day revealed a large ulcerated mass in the cecum that, under microscopy, was found to be moderately differentiated adenocarcinoma. Around that time, blood cultures began to grow out Clostridium septicum. The patient was offered surgical intervention, but refused; she was treated with antibiotics and discharged home with hospice, dying exactly 1 week later.Figure 1: Computed tomography angiography of the abdomen and pelvis revealing air in the aortic wall.Figure 2: Colonoscopy revealing a large ulcerated cecal mass.