Sepsis Caused by Clostridium Perfringens in an Elderly Female Patient with Breast Cancer: A Case Report

To report a rare case of a breast cancer patient who developed septic shock and multiple organ injury. It analyzes the clinical characteristics, pathogenic factors, and prognosis associated with a mixed infection caused by Clostridium perfringens and Escherichia coli, aiming to provide a reference for the early identification and intervention of similar clinical cases.

A retrospective analysis was conducted on the clinical data of a 75-year-old female patient with breast cancer, who also had a history of hypertension and diabetes. The clinical manifestations, results of etiological tests, treatment regimen, and patient outcomes were summarized, along with an analysis based on existing literature.

The patient was admitted due to nausea, vomiting, abdominal pain, diarrhea, fever, and loss of consciousness, accompanied by acute myocardial infarction and progressively worsening shock. A diagnosis of septic shock and multiple organ injury was established. Etiological tests confirmed an infection with Clostridium perfringens type A carrying the plc(α) toxin gene, as well as Escherichia coli. Despite receiving anti-infective treatment with meropenem, the patient succumbed to multiple organ failure, including heart failure, within less than four days. This case represents the third documented instance of breast cancer patients complicated by Clostridium perfringens bacteremia in the medical literature. Based on clinical manifestations, the source of infection was presumed to be gastrointestinal, with a potential predisposing factor related to the patient's consumption of watermelon on that had been left unrefrigerated for over 24 hours. Although bloodstream infections caused by Clostridium perfringens are relatively rare, accounting for only about 0.017% of all bloodstream infections, the mortality rate can be as high as 70% to 100% in immunocompromised patients and those with malignant tumors.

When immunocompromised patients with a history of malignant tumors present with infectious symptoms such as fever, myocardial injury, and hemolysis, the potential for infection by virulent anaerobes, such as Clostridium perfringens, should be considered. Early identification and targeted intervention are crucial for improving the prognosis of these patients.