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Acute necrotizing bacterial tonsillitis with Clostridium perfringens.
1Forensic Medical, Metropolitan Davidson County, Nashville, Tennessee 37210, USA.
Summary
Clostridium perfringens rarely infects tonsils, but a case study revealed it caused acute necrotizing tonsillitis in an infant. This highlights the importance of examining tonsils for systemic Clostridium perfringens infections.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Pathology
Background:
- Clostridium perfringens infections in young children are typically linked to meningitis, gastrointestinal issues, or post-surgical complications.
- Literature searches indicate no prior documented cases of Clostridium perfringens infecting the tonsils.
Observation:
- An otherwise healthy 9-month-old infant presented with unresponsiveness and was pronounced dead shortly after hospital admission.
- Autopsy revealed shock and acute necrotizing bacterial tonsillitis, initially misdiagnosed as sudden infant death syndrome or smothering.
Findings:
- Postmortem cultures of cerebrospinal fluid, blood, and lungs yielded pure Clostridium perfringens.
- Microscopic examination of the tonsils showed numerous gram-positive rods consistent with Clostridium perfringens, despite no significant gross lesions.
Implications:
- This case suggests tonsillar infection by Clostridium perfringens can lead to fatal systemic illness in infants.
- Sampling Waldeyer's ring tissues, particularly tonsils, is crucial for diagnosing systemic infectious diseases entering through the oropharynx.