Septicum Bacteremia Research Articles

Clostridium Septicum: Cause of Gas Gangrene in the Upper Extremity Leading to Proximal Trans-Humeral Amputation, A Review of Clostridium septicum

Introduction: Gas gangrene is a rare, often lethal infection of soft tissue that is commonly associated with the Clostridial species due to penetrating injuries. Case reports of spontaneous atraumatic gas gangrene due to the Clostridium septicum species are exceedingly rare. Atraumatic C. septicum is notably related to bowel pathologies, immunodeficiencies, and individuals with vascular insufficiency. The rapid progression of Clostridium myonecrosis contributes to its high mortality rates. Case Report: The authors report a case of a 71-year-old right-hand-dominant female who developed fulminant atraumatic left forearm pain and swelling. The patient was indicated for emergent irrigation and debridement (I&D) of the left upper extremity. She was later found to have C. septicum bacteremia and required multiple I&Ds including the left side of the neck and chest wall. Repeat post-operative examinations revealed no motor function or sensation distal to the elbow and she was subsequently indicated for a proximal trans-humeral amputation. Conclusion: Although she had a prolonged hospital stay, she progressed well and was eventually discharged to a rehabilitation facility. This case report highlights the importance of early recognition of Clostridial myonecrosis as well as the need for emergent surgical intervention for the patient’s survival. Keywords: Trans-humeral amputation, gas gangrene, Clostridium septicum infection.

CLOSTRIDIUM SEPTICUM FASCIITIS IN A PATIENT WITH OCCULT COLON MALIGNANCY: A CASE REPORT AND LITERATURE REVIEW

Introduction and aim. Gas gangrene is usually related to a trauma and can involve different districts of the body. It is a life-threatening condition, and its consequences lead to functional and aesthetical deficit. Atraumatic gas gangrene is a rare event, sometimes related to a Clostridium septicum (C. septicum) bacteremia. Aim of this article is to discuss existing literature about relation between colon adenocarcinoma and Clostridia infections, integrating with a case-report. Patients and methods. A 54-year-old obese female patient developed an atraumatic gas gangrene of the posterior trunk, started from a C. septicum bacteremia. Gas gangrene involved skin, soft tissues and muscles of the back. A multidisciplinary clinical and surgical management involved anesthesiologists, general and plastic surgeons. During hospitalization, an occult colon adenocarcinoma was diagnosed and recognized as the bacteremia trigger, and it was successfully addressed. The gangrene was properly treated with seriate surgical debridement and final soft tissue coverage. After a long hospital stay, the patient was discharged in stable clinical conditions. Results and conclusions. C. septicum gas gangrene remains one of the most fearful infections. An early diagnosis and a prompt antibiotic and surgical treatment, with life supportive care, are mandatory to avoid the necrotizing fasciitis spreading and the death of the patient. However, due to the rarity and variability of this condition, there is no standardized protocol for its treatment. Since a strong relation between C. septicum infection and colon malignancy is reported in literature, in cases of C. septicum bacteremia it should be mandatory to investigate gastrointestinal tract to exclude colon malignancy.

Anterior spinal artery syndrome due to Clostridium septicum aortitis

Anterior spinal artery syndrome due to Clostridium septicum aortitis

Clostridium septicum bacteremia resulting from traumatic myonecrosis: A Case report

Clostridium septicum bacteremia resulting from traumatic myonecrosis: A Case report

Shiga Toxin 2 Mediated Hemolytic Uremic Syndrome Complicated By Clostridium Septicum Bacteremia in a 4-Year-Old

Shiga toxin 2 (Stx2) is a potent toxin produced by shiga toxin-producing <em>E. coli</em> (STEC) that is commonly linked to development of hemolytic uremic syndrome (HUS). An extremely rare complication of shiga toxin associated (STEC) hemolytic uremic syndrome is concomitant infection with <em>Clostridium septicum</em>.

Clostridium septicum Triad

Abstract Infected aortic aneurysm is a rare occurrence accounting for 2.6% of described aneurysms. Staphylococcus species and Salmonella species are the most frequently isolated microbes, with Clostridium septicum being decidedly less commonly detected. It is well documented that C. septicum bacteremia in the presence of an infected aneurysm is strongly associated with gastrointestinal cancer, particularly colorectal adenocarcinoma. Although blood cultures were repeatedly negative, a left pleural effusion culture grew C. septicum. The patient was treated with an endovascular prosthesis and prolonged antibiotic therapy including lifelong suppression. Serial abdominal computed tomographic scans with contrast displayed an enlarging appendiceal lesion that was described as a mucocele. Surgical histopathology revealed an invasive moderately differentiated adenocarcinoma. This case highlights both the association of C. septicum with malignancy and the utility of pleural effusion culture in the presence of culture-negative infected aortic aneurysm.

Emphysematous Aortitis Caused by Clostridium Septicum Bacteremia

Emphysematous Aortitis Caused by Clostridium Septicum Bacteremia

Colon Cancer Heralded by Clostridium septicum bacteremia

Colon Cancer Heralded by Clostridium septicum bacteremia

Temsirolimus therapy and small bowel perforation in a pediatric patient with Clostridium septicum bacteremia

Abstract Temsirolimus has been demonstrated to result in significant disease stabilization in children with high-grade glioma, neuroblastoma, and rhabdomyosarcoma. While mucositis has been reported as a common adverse effect of temsirolimus therapy in adult and pediatric patients, bowel perforation is an infrequent and life-threatening side effect of temsirolimus in adults and has not previously been reported in children. We present a child treated with temsirolimus for recurrent metastatic rhabdomyosarcoma who underwent ileocecectomy and small bowel resection for perforation with frank necrosis. His presentation was complicated by Clostridium septicum infection, a rare, frequently fatal, gastrointestinal pathogen associated with malignancy and bowel ischemia.

Spontaneous remission of acute monocytic leukemia after infection with Clostridium septicum

Spontaneous remissions of acute myeloid leukemia (AML) have been reported in association with infection. Here, we report a case of spontaneous remission of AML in a 47-year-old Saudi Arabian male patient who presented with a few weeks history of recurrent abdominal pain, vomiting and fever. He was diagnosed with acute monocytic leukemia (AML, FAB M5b) and a perforated bowel. He also had Clostridium septicum bacteremia and thus chemotherapy was deferred. He received supportive therapy and intravenous antibiotics. Six weeks later, he achieved spontaneous and complete remission lasting for about 4 months. The remission and relapse were documented by bone marrow examination. Similarly, previous reports of spontaneous remission of AML were short lived and were followed by relapse and progression.

Clostridium septicum Bacteremia Without Gas Gangrene as a Late Consequence of a Contaminated Wound

Clostridium septicum is an unusual human pathogen associated with colorectal malignancy and gas gangrene. A case compilation and literature review are presented. We report the case of an individual with a comminuted tibial fracture complicated by a superficial surgical site infection with C. septicum nine weeks after the original injury and internal fixation, which was complicated by a secondary bacteremia. This is a unique case in the literature, but it is suggested that the use of cephalosporins as prophylaxis for contaminated wounds may be inferior to penicillins to prevent clostridial infections.

The Role of Clostridium septicum in Paraneoplastic Sepsis

Abstract Context.—Clostridium septicum infections are rare but often associated with serious if not fatal outcomes. Clostridium septicum infection does not appear to be associated with a single specific defect in cellular or humoral immunity. It has been associated with multiple medical problems, including but not limited to leukemia, malignancy of the bowel, other solid tumors, cyclic neutropenia with enterocolitis, diabetes mellitus, and severe arteriosclerosis. Most cases of C septicum are associated with malignancy, and mortality approaches 100% if care is not rendered within 12 to 24 hours. Objectives.—To evaluate outcomes of patients with C septicum bacteremia, whether treated medically or surgically or both, and to note associated conditions. Design.—Retrospective evaluation of patients found to have C septicum bacteremia in the past 6 years. Setting.—Two teaching hospitals, Brooke Army Medical Center (250 beds) and Wilford Hall Medical Center (292 beds), were the source of our patients. Patients.—...

Clostridium septicum bacteremia associated with aortic graft infection

After emergency repair of a ruptured abdominal aortic aneurysm associated with an aortocaval fistula, Clostridium septicum sepsis prompted evaluation for colon cancer. Adenocarcinoma of the right colon ultimately required hemicolectomy, after which the patient had development of recurrent C. septicum bacteremia. Computed tomography scanning demonstrated a large fluid collection surrounding the aortic graft, and percutaneous drainage documented recurrent C. septicum. Initial axillobifemoral bypass was followed by removal of the patient's aortic graft and retroperitoneal drainage. After 3 years the patient is without evidence of recurrent infection or tumor. This case report consists of a known instance of C. septicum infection of an aortic graft.

Clinical courses of seven survivors of Clostridium septicum infection and their immunologic responses to alpha toxin.

Clostridium septicum bacteremia typically portends a fulminant disease associated with high mortality. We describe the clinical courses of seven survivors of C. septicum infection and their antibody responses to the alpha toxin produced by C. septicum. Three patients had clinical syndromes ranging from uncomplicated bacteremia to early typhlitis, and three patients had syndromes ranging from abscess to myonecrosis and septic shock. In addition, an AIDS patient who developed septic shock and who had extensive gas in the retroperitoneal musculature did not undergo surgery but survived after receiving antimicrobial therapy and intensive supportive care. Both immunocompetent patients with myonecrosis had detectable IgG to alpha toxin by immunoblot analysis. IgG to alpha toxin was not detected in the four immunocompetent patients who had C. septicum bacteremia but who did not have myonecrosis or in the AIDS patient with myonecrosis. Therefore, humoral responses to alpha toxin during C. septicum infection may be related to the host's clinical syndrome and immune status.

Histopathologic effects of culture filtrates of Clostridium septicum in rabbit intestinal loops.

Clostridium septicun is pathogenic for humans and animals and is one of the clostridia capable of potentiating myonecrosis following traumatic injury. In recent years, this organism has been implicated in nontraumatic infections including spontaneous myonecrosis, neutropenic enterocolitis, and bacteremia [1-3]. Such nontraumatic infections are increasingly being diagnosed in individuals suffering from malignancy, neutropenia, diabetes, or severe atherosclerosis, and they tend to be fulminant and associated with high rates of mortality unless treated promptly and aggressively with surgical measures and antimicrobial agents. In patients with C. septicumn bacteremia, the most frequently implicated portal of entry has been the intestinal tract, with or without concomitant neoplastic disease. Autopsies have revealed necrotizing inflammation of the terminal ileum and cecum, and some neutropenic patients with C. septicum bacteremia have died with necrotizing enterocecitis (author's unpublished data) [1]. C. septicum is known to elaborate a variety of potential virulence factors, including two hemolysins, deoxyribonuclease, hyaluronidase, neuraminidase, and fibrinolysin. Previous studies performed in our laboratory showed that crude cell-free culture filtrates of C. septicurn were cytotoxic for Vero and other cell lines. The object of this preliminary study was to survey the responses of rabbit intestinal loops to cell-free culture filtrates of the organism and to compare the histopathologic changes that it causes with those produced by Clostridium difficile. In this preliminary study, we found that the majority of the C. septicum isolates tested produced significant fluid accumulation and histological changes within the rabbit intestinal loop model that were similar to those produced by C. difficile. All 17 strains of C. septicum used in this study were selected from the culture collection of the Anaerobe Labora-

Mycotic Aortic Aneurysm Infected by Clostridium septicum — A Case History

The authors describe a sixty-seven-year-old hypertensive, diabetic man with a mycotic abdominal aortic aneurysm infected with Clostridium septicum. The patient had colonic polyps but no malignant disease. They could find only one other report of a mycotic aneurysm infected with C. septicum. In that case, as in most other cases of C. septicum bacteremia, the patient had gastrointestinal cancer. Their case suggests that treatment for a clostridial infection should be considered in patients with known gastrointestinal disease, signs and symptoms of sepsis, and abdominal pain. Conversely, patients known to have a C. septicum infection should be evaluated for gastrointestinal lesions.

Clostridium septicum Bacteremia and Diffuse Spreading Cellulitis of the Head and Neck in a Leukemic Patient

Clostridium septicum Bacteremia and Diffuse Spreading Cellulitis of the Head and Neck in a Leukemic Patient

Clostridium septicum septicemia with identical metastatic myonecroses in a granulocytopenic patient. Infectious disease emergency

Clostridium septicum is a gram-positive, sporulating spindle-shaped rod. Gas gangrene secondary to trauma is not uncommon. However, nontraumatic clostridial infection causing myonecrosis is quite unusual. This is a unique case report of Clostridium septicum bacteremia with two simultaneously evolving metastatic foci of myonecrosis of the left arm and right thigh that developed in a patient with lymphoma when he became granulocytopenic during his hospital course.

Clostridium septicum bacteremia its clinical significance

The medical records of 59 patients with Clostridium septicum bacteremia were reviewed; 42 (71 per cent) of these patients had malignancies. One half had hematologic malignancies, and one half had solid tumors. Of the 21 patients with solid tumors, 14 (67 per cent) had cancer of the colon. Among these patients, the cecum was the most frequent site of malignancy. The cecum and distal ileum were the most probable portals of entry for C. septicum bacteremia among the 28 patients examined at autopsy. Patients admitted to the hospital with C. septicum bacteremia usually have fulminating clinical courses and, unless the appropriate antibiotics are administered soon after admission, the outcome is fatal. The results of this study demonstrate the high association of C. septicum bacteremia and malignancy, and the need for early recognition and therapy.