Abstract
Life-threatening soft tissue infections caused by Clostridium species have been described in the medical literature for hundreds of years largely because of their fulminant nature, distinctive clinical presentations and complex management issues. The Clostridium species perfringens, septicum and histolyticum are the principal causes of trauma-associated gas gangrene and their incidence increases dramatically in times of war, hurricanes, earthquakes and other mass casualty conditions; more recently such infections have developed in injecting drug users. Spontaneous gas gangrene caused by C. septicum has increased in association with gastrointestinal abnormalities and neutropenia. Similarly, there has been increased recognition of a toxic shock-like syndrome associated with C. sordellii in women undergoing childbirth or other gynaecological procedures including medically induced abortion. The pathogenesis of these clostridial infections is largely the consequence of potent exotoxin production. Strategies to inhibit toxin production, neutralize circulating toxins and prevent their interaction with cells of the innate immune response are sorely needed. Recent studies have elucidated novel targets that may hold promise for newer therapeutic modalities.
Published Version
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