Abstract
Clostridia are uncommon causes of pleuropulmonary infection. Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura. Most cases have iatrogenic causes usually due to invasive procedures into the pleural cavity, such as thoracentesis or thoracotomy, or penetrating chest injuries. Rarely clostridia pleuropulmonary infections are not related to these factors. The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal. We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman.
Highlights
Clostridia are uncommon causes of pleuropulmonary infection, especially in nonsurgical or nontraumatic patients [1]
We present the case of a 82-years-old caucasian female, affected by paroxysmal atrial fibrillation, hypertension, normochromic normocytic anemia, arthritis, osteoporosis, cholelithiasis, admitted to our department for worsening
Spontaneous pneumonia related to clostridium perfringens has rarely been described in the medical literature, while this condition seems more commonly associated with invasive procedures or penetrating chest injuries
Summary
Clostridia are uncommon causes of pleuropulmonary infection, especially in nonsurgical or nontraumatic patients [1]. Other predisposing factors for necrotizing pneumonia are aspiration of oropharyngeal or gastric contents [1,2,3,4], pulmonary embolism with infarction (haematogenous seeding of infarcted lung tissue) [1] This condition is often associated with chronic disease, such as diabetes or cirrhosis, and underlying pleuropulmonary pathology (pulmonary tuberculosis, chronic pleural effusions) [2,4]. The chest X-ray showed aspecific findings of bilateral pleural effusion with consolidation of lower lobes and lingula It was undertaken oxygen therapy, hydrating, diuretic and empirical antibiotic therapy with cephalosporins and macrolides and blood cultures were performed. In the following weeks patient health conditions improved and a CT scan of the chest performed after two weeks of treatment showed marked reduction of pleural effusion and of extent of parenchymal consolidation with disappearance of cavitating areas. The patient fully recovered and she did not show any sign or symptom of pleuropulmonary disease
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