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Published on: June 15, 2018
Clostridium septicum arthroplasty infection: beware of occult aortitis and malignancy
Gareth Turnbull1, Euan Spierits1, David Russell2
1Clinical Research Fellow, Department of Orthopaedic Surgery, Golden Jubilee National Hospital, UK.
Introduction:
The Clostridia species are responsible for life-threatening conditions such as tetanus, botulism and gas gangrene. Clostridium septicum is a rare cause of clinical infection, accounting for less than 1% of blood culture samples that test positive for Clostridia. However, C. septicum bacteraemia is associated with greater than 60% mortality and in over 80% of cases is associated with an underlying malignancy.
Case Presentation:
We present a review of the literature and the first case of an acute arthroplasty infection and concurrent infective aortitis caused by this organism in the absence of an identified underlying malignancy. Early diagnosis and multi-disciplinary input resulted in the patient surviving a rare and potentially fatal infective aortitis and septic arthritis.
Conclusion:
This case demonstrates the importance of early systemic investigation to exclude occult infective aortitis in C. septicum infection. The key role of multi-disciplinary input into the management of this often fatal infection is also discussed along with the requirement to exclude occult gastrointestinal and haematological malignancy.
Insights
Clostridium septicum bacteraemia, though rare, carries a high mortality rate and is often linked to malignancy. This case highlights survival through early diagnosis and multidisciplinary care for C. septicum-induced infective aortitis and septic arthritis.
Area of Science:
- Infectious Diseases
- Bacteriology
- Critical Care Medicine
Background:
- Clostridia species cause severe infections like tetanus and gas gangrene.
- Clostridium septicum is a rare pathogen, but C. septicum bacteraemia has a high mortality rate (>60%).
- Over 80% of C. septicum infections are associated with underlying malignancies.
Purpose of the Study:
- To report the first case of acute arthroplasty infection and concurrent infective aortitis caused by C. septicum without an identified underlying malignancy.
- To emphasize the importance of early systemic investigation for C. septicum infections.
- To highlight the role of multidisciplinary input in managing rare, fatal infections.
Main Methods:
- Literature review.
- Case report of a patient with C. septicum-induced acute arthroplasty infection and infective aortitis.
- Focus on diagnostic and management strategies.
Main Results:
- The patient survived a rare and potentially fatal presentation of infective aortitis and septic arthritis.
- Early diagnosis and multidisciplinary management were crucial for patient survival.
- The absence of an identified underlying malignancy in this specific case was noted.
Conclusions:
- Early systemic investigation is critical to rule out occult infective aortitis in C. septicum infections.
- Multidisciplinary team input is essential for managing C. septicum infections.
- Exclusion of occult gastrointestinal and hematological malignancies remains important in C. septicum cases.
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