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Clostridium septicum infection and malignancy

M R Katlic, W M Derkac, W S Coleman

    Annals of Surgery
    |March 1, 1981
    PubMed
    Summary

    Clostridium septicum infection is strongly linked to various cancers, especially blood and intestinal malignancies. Early surgical intervention is crucial for survival in patients with this severe infection.

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    Area of Science:

    • Infectious Diseases
    • Oncology
    • Surgical Pathology

    Background:

    • The association between Clostridium septicum infection and malignancy, particularly hematologic or intestinal types, is increasingly recognized but not fully understood.
    • This study examines seven patients with C. septicum gangrene or sepsis treated between 1977-1979.

    Observation:

    • All seven patients had concurrent malignant disease, including colon adenocarcinomas, acute myeloblastic leukemias, and breast carcinoma.
    • In most cases, the malignancy was advanced, though one patient had a remote history of breast cancer.
    • A gastrointestinal portal of entry was suspected in five patients.

    Findings:

    • Prompt antibiotic treatment was administered, but survival was limited to patients who received early, extensive surgical debridement.
    • Two of four patients with C. septicum infection and malignancy survived, both undergoing early debridement.

    Implications:

    • Clinicians should investigate for malignancy in patients with C. septicum infection.
    • C. septicum should be considered in septic patients with known cancer.
    • The cecum or distal ileum may be primary sites of infection in cases of clostridial myonecrosis or sepsis without an obvious external source.
    • Increased awareness and aggressive surgical management of C. septicum infections may improve the current high mortality rate.

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