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Clostridium bacteremia and its implications: A case report
Sruthi Bonda1, Kevin Lee1, John Rovig1
1Department of Internal Medicine, University of Nevada, Las Vegas, 1707 W Charleston Blvd. Suite 100, Las Vegas, NV 89102, United States.
Idcases
|June 6, 2022
Summary
This case highlights rare Clostridium bacteremia caused by C. septicum and C. tertium in an elderly patient with colon perforation. Prompt evaluation for gastrointestinal sources and appropriate treatment are crucial for Clostridium infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium species are gram-positive, anaerobic bacteria known for toxin production, with C. botulinum, C. difficile, and C. perfringens being common pathogens.
- Less common but clinically significant species include C. septicum and C. tertium, which can cause severe infections.
Observation:
- A 79-year-old patient with a history of prostate cancer and alcohol abuse presented with septic shock.
- Blood cultures revealed C. septicum, C. tertium, and E. coli bacteremia.
- Abdominal imaging indicated pneumoperitoneum and pericolic fluid collection, suggestive of colon perforation.
Findings:
- The patient underwent an exploratory laparotomy and total colectomy due to developing abdominal distention and tenderness.
- Three separate colon perforations were identified, with no evidence of malignancy on histopathology.
- C. septicum is a virulent pathogen associated with various invasive infections and malignancies, while C. tertium is often linked to immunocompromised states and has lower virulence.
Implications:
- This case underscores the importance of investigating gastrointestinal sources in patients with Clostridium bacteremia.
- Prompt and appropriate treatment is essential for managing Clostridium infections, particularly those involving less common species.
- Understanding the distinct virulence and risk factors of C. septicum and C. tertium aids in clinical management.
