Septic Shock Due to Clostridium perfringens

Raynieri Fernandez,Andrea Anampa-Guzmán

doi:10.7759/cureus.4262

Abstract

Clostridium perfringens is an anaerobic Gram-positive bacterium. We present the case of a 75-year-old female presented to the emergency department with progressively worsening acute on chronic left hip pain. It was not until the third day of hospitalization when the initial blood cultures finalized as Clostridium perfringens, antibiotics were changed to piperacillin-tazobactam and clindamycin. Despite the latest measurements, the patient continued getting hypotensive and progressed to multiorgan failure resulting in death by the end of the third day. The recognition of risk factors in addition to gram-positive rod cultures in the setting of septic shock reinforces the importance of appropriate and early empiric antibiotics management and infectious disease consultation to avoid fatal complications.

Highlights

Clostridium perfringens is an anaerobic Gram-positive bacterium that can be found in the gastrointestinal tract, female genital tract, and on the skin
Clostridial toxic shock syndrome is a lifethreatening, rapidly progressive toxigenic illness that can be caused by infection of Clostridium perfringens [3]
Generic Interpretation Numeric 0.016 SUSCEPTIBLE 1.0 SUSCEPTIBLE >=256 RESISTANT 0.19 SUSCEPTIBLE 0.75 SUSCEPTIBLE. It was not until the third day of hospitalization when the initial blood cultures finalized as Clostridium perfringens (Table 2)

Summary

Introduction

Clostridium perfringens is an anaerobic Gram-positive bacterium that can be found in the gastrointestinal tract, female genital tract, and on the skin. The patient is a 75-year-old female with a past medical history of chronic obstructive pulmonary disease, type 2 diabetes mellitus, atrial fibrillation not on anticoagulation She had multiple hospital admission due to urinary tract infection and left hip pain due to fracture status post open reduction and internal fixation three months before that presented to the emergency department with acute on chronic left hip pain. A non-tunneled central line catheter was placed for urgent hemodialysis Before this was able to be done the patient became hypotensive and tachycardic, not responsive to aggressive intravenous fluids resuscitation, requiring initiation of vasopressors. Generic Interpretation Numeric 0.016 SUSCEPTIBLE 1.0 SUSCEPTIBLE >=256 RESISTANT 0.19 SUSCEPTIBLE 0.75 SUSCEPTIBLE It was not until the third day of hospitalization when the initial blood cultures finalized as Clostridium perfringens (Table 2). The patient continued getting hypotensive and progressed to multiorgan failure resulting in death by the end of the third day

Discussion

Conclusions

Disclosures