Clostridial species in the pathogenesis of necrotizing enterocolitis in patients with neutropenia

The role of gram-negative bacteria in the pathogenesis of necrotizing enterocolitis has been stressed. We describe a 21-year-old woman with chronic neutropenia with cyclic fluctuations who died of necrotizing enterocolitis due to Clostridium septicum. Seven patients with cyclic neutropenia and necrotizing enterocolitis have been described in the literature and in each case in which bacteriologic data were reported, a Clostridial infection was documented. Patients with cyclic neutropenia should be treated with antibiotics effective against Clostridial species when abdominal symptoms complicate neutropenic periods.