Aortitis due to metastatic gas gangrene

Clostridium septicum bacteremia and its association with hematologic malignancy and colorectal cancer have been well recognized. Panwalker, in a recent review, discussed clostridial sepsis and other unusual infections associated with colorectal tumors, including streptococcal bovis and Bacteroides. He reports the coexistence of colorectal cancer and metastatic Clostridium septicum infections at multiple sites. We describe a case in which a patient with an occult cecal carcinoma develops Clostridium septicum sepsis and thoracic aortitis secondary to metastatic gas gangrene. This dramatic and unusual complication has not previously been documented. The necessity of colonic evaluation with Clostridium septicum bacteremia is discussed.