Clostridial septicemia.

Abstract

Fifteen episodes of Clostridia species septicemia were evaluated in 14 patients with neoplastic disease. Seven of these were in patients with leukemias and lymphomas, 4 in the former and 3 in the latter. All episodes except one appeared to originate in the bowel and were usually accompanied by signs of intestinal obstruction. All patients, except one with a necrotic epidermoid carcinoma of the pharynx, had extensive and widespread neoplastic disease, and 11 of the 15 episodes occurred in association with either antineoplastic chemotherapy, radiation therapy, or both. In 6 of the 14 patients, infection closely followed some surgical or diagnostic procedure. In two patients, noteworthy straining at stool preceded clinical sepsis by 1 to 3 hours. The clinical picture was not uniform, and signs such as alertness despite hypotension, pulse-temperature deficit, hemolysis, and subcutaneous crepitation were the exception rather than the rule. Three patients showed response to high-dose penicillin and supportive therapy. The treatment of clostridial sepsis, which includes removal of the source when possible as well as high-dose pencillin, should be prompt, for all our patients who died, with one exception, did so within 24 hours of the onset of clinical sepsis.