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Case of Clostridium perfringens bacteremia after routine colonoscopy and polypectomy
Anjali N Kunz1, Diana Riera, Patrick Hickey
1Walter Reed Army Medical Center, Department of Pediatrics MCHL-K 6900 Georgia Avenue, NW Washington DC 20307, USA. kdocs2002@verizon.net
Insights
Clostridium perfringens bacteremia is a rare complication following polypectomy, especially in children. Early antibiotic treatment is crucial for favorable outcomes in such cases.
Area of Science:
- Microbiology
- Pediatric Gastroenterology
Background:
- Bacteremia is a rare complication post-polypectomy and colonoscopy.
- Clostridium perfringens bacteremia is exceptionally uncommon, particularly in pediatric patients.
Observation:
- A 4-year-old boy with congenital polyposis developed fever and tachycardia 12 hours after a colonoscopy and polypectomy.
- Blood cultures revealed penicillin-susceptible Clostridium perfringens and Enterococcus faecalis.
Findings:
- This case represents one of the first documented instances of Clostridium perfringens bacteremia following polypectomy in a pediatric patient.
- The patient responded well to antibiotic therapy, showing resolution of symptoms.
Implications:
- Polymicrobial infections, including anaerobic organisms like C. perfringens, can occur post-polypectomy and may indicate a poor prognosis.
- Empiric antibiotic therapy for post-polypectomy fever should consider coverage for anaerobic infections, especially in pediatric cases.
- Prompt diagnosis and treatment of Clostridial bacteremia are vital to prevent severe complications.
Abstract:
Bacteremia is an uncommon complication after polypectomy and colonoscopy. We report one of the first cases of Clostridium perfringens bacteremia after polypectomy. Our patient was a four years old boy with congenital polyposis, who underwent colonoscopy and polypectomy without complication. Approximately 12h later he developed a fever and tachycardia with no other clinical symptoms. His blood cultures grew out penicillin susceptible C. perfringens and Enterococcus faecalis. He responded to antibiotic therapy and remained clinically asymptomatic for the duration of his course. There are a few reports of bacteremia after routine polypectomy, but no reported cases of C. perfringens bacteremia in the pediatric population. Clostridial sp. bacteremia can be fatal with devastating consequences if appropriate antibiotics and/or surgical debridement are delayed. Polymicrobial infection, as illustrated in our patient, is also common and can be a poor prognostic risk factor. Therefore, for patients with a history of polypectomy and new onset fever, anaerobic infections should be considered and empiric antibiotic therapy should include coverage for these organisms.
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