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Clostridium bacteremia and its implications: A case report

BACKGROUND: The Clostridium species is a gram positive, anaerobic, rod-shaped microbe that is known to produce many toxins. Most infections by the Clostridium species involve C. botulinum, C. difficile, and C. perfringens. However, other types of Clostridium species are also clinically relevant, suc...

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Detalles Bibliográficos
Autores principales: Bonda, Sruthi, Lee, Kevin, Rovig, John, Asad, Shadaba
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157464/
https://www.ncbi.nlm.nih.gov/pubmed/35663607
http://dx.doi.org/10.1016/j.idcr.2022.e01516
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author Bonda, Sruthi
Lee, Kevin
Rovig, John
Asad, Shadaba
author_facet Bonda, Sruthi
Lee, Kevin
Rovig, John
Asad, Shadaba
author_sort Bonda, Sruthi
collection PubMed
description BACKGROUND: The Clostridium species is a gram positive, anaerobic, rod-shaped microbe that is known to produce many toxins. Most infections by the Clostridium species involve C. botulinum, C. difficile, and C. perfringens. However, other types of Clostridium species are also clinically relevant, such as C. septicum and C. tertium. CASE SUMMARY: We discuss a case of a 79-year-old patient with a past medical history of prostate cancer and alcohol abuse who presented to the hospital after being found down. They were admitted to the ICU for septic shock, and initial blood cultures grew C. septicum, C. tertium, and E. coli. A CT of the abdomen and pelvis with IV contrast showed pneumoperitoneum and a loculated pericolic fluid collection concerning for colon perforation. Initially the patient had a benign abdominal exam, but later developed significant distention and tenderness that required an emergent exploratory laparotomy and total abdominal colectomy. The patient was found to have three separate colon perforations, and no malignancy on histopathology. DISCUSSION: C. septicum is a highly virulent pathogen, and there are several cases reporting C. septicum-associated endocarditis, aortitis, and endophthalmitis. It is also associated with colon and hematologic malignancies and neutropenia. Common risk factors for C. tertium include immunocompromised status, neutropenia, hematologic malignancy, exposure to beta-lactam antibiotics, cirrhosis, and intestinal mucosal damage. It seems to have low virulence and low mortality when treated correctly. It is important that any patient found to have Clostridium bacteremia be evaluated for a gastrointestinal source and treated promptly and appropriately.
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spelling pubmed-91574642022-06-02 Clostridium bacteremia and its implications: A case report Bonda, Sruthi Lee, Kevin Rovig, John Asad, Shadaba IDCases Case Report BACKGROUND: The Clostridium species is a gram positive, anaerobic, rod-shaped microbe that is known to produce many toxins. Most infections by the Clostridium species involve C. botulinum, C. difficile, and C. perfringens. However, other types of Clostridium species are also clinically relevant, such as C. septicum and C. tertium. CASE SUMMARY: We discuss a case of a 79-year-old patient with a past medical history of prostate cancer and alcohol abuse who presented to the hospital after being found down. They were admitted to the ICU for septic shock, and initial blood cultures grew C. septicum, C. tertium, and E. coli. A CT of the abdomen and pelvis with IV contrast showed pneumoperitoneum and a loculated pericolic fluid collection concerning for colon perforation. Initially the patient had a benign abdominal exam, but later developed significant distention and tenderness that required an emergent exploratory laparotomy and total abdominal colectomy. The patient was found to have three separate colon perforations, and no malignancy on histopathology. DISCUSSION: C. septicum is a highly virulent pathogen, and there are several cases reporting C. septicum-associated endocarditis, aortitis, and endophthalmitis. It is also associated with colon and hematologic malignancies and neutropenia. Common risk factors for C. tertium include immunocompromised status, neutropenia, hematologic malignancy, exposure to beta-lactam antibiotics, cirrhosis, and intestinal mucosal damage. It seems to have low virulence and low mortality when treated correctly. It is important that any patient found to have Clostridium bacteremia be evaluated for a gastrointestinal source and treated promptly and appropriately. Elsevier 2022-05-20 /pmc/articles/PMC9157464/ /pubmed/35663607 http://dx.doi.org/10.1016/j.idcr.2022.e01516 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bonda, Sruthi
Lee, Kevin
Rovig, John
Asad, Shadaba
Clostridium bacteremia and its implications: A case report
title Clostridium bacteremia and its implications: A case report
title_full Clostridium bacteremia and its implications: A case report
title_fullStr Clostridium bacteremia and its implications: A case report
title_full_unstemmed Clostridium bacteremia and its implications: A case report
title_short Clostridium bacteremia and its implications: A case report
title_sort clostridium bacteremia and its implications: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157464/
https://www.ncbi.nlm.nih.gov/pubmed/35663607
http://dx.doi.org/10.1016/j.idcr.2022.e01516
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