Spontaneous Clostridium perfringens lung abscess unresponsive to penicillin
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L Baldwin1, A Henderson, M Wright
1Intensive Care Unit, Princess Alexandra Hospital, Woollongabba, Brisbane, Queensland, Australia.
Abstract:
Clostridial necrotising pneumonia is a rare complication of aspiration, bronchial tumour or foreign body, pulmonary infarction, trauma and debilitating medical conditions. Although spontaneous clostridial pneumonia has been reported previously, close scrutiny of those case reports suggests that most of the patients had a recognised predisposing cause. We report a case of true spontaneous Clostridium perfringens pneumonia complicated by septic shock, pneumothorax and pulmonary necrosis. The patient responded poorly to conventional treatment with benzylpenicillin, and although the addition of metronidazole produced dramatic resolution of the sepsis, lobectomy was required to effect cure.
Insights
True spontaneous Clostridium perfringens pneumonia is a rare condition. This case highlights the need for aggressive treatment including antibiotics and surgery for severe Clostridium perfringens pneumonia.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonology
Background:
- Clostridial necrotising pneumonia is a rare lung infection.
- It is typically associated with predisposing factors like aspiration or trauma.
Observation:
- We present a rare case of spontaneous Clostridium perfringens pneumonia.
- The patient developed severe complications including septic shock, pneumothorax, and pulmonary necrosis.
Findings:
- Conventional treatment with benzylpenicillin was ineffective.
- Adding metronidazole improved sepsis, but surgical intervention (lobectomy) was necessary for cure.
Implications:
- This case underscores the aggressive nature of spontaneous Clostridium perfringens pneumonia.
- Prompt and comprehensive treatment, potentially including surgery, is crucial for patient survival.