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Peng J, Zhai Q, Li J, Chen X, Wu H, Zhong T, Tang G, Yu D, He L, Li J. Clostridium perfringens Liver Abscess Disguised as Biliary Disease: A Report of Two Cases and a Review of the Literature. Infect Drug Resist 2023; 16:5209-5222. [PMID: 37589015 PMCID: PMC10426438 DOI: 10.2147/idr.s415347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
Liver abscesses caused by Clostridium perfringens are rare but rapidly fatal. In only a few days, patients progress from liver abscess to sepsis, intravascular hemolysis, multiple organ failure, and even death. These abscesses often occur in patients after trauma or surgery or in those with immunodeficiency. Because patients only show non-specific symptoms such as fever and abdominal pain in the early stage, they can easily be misdiagnosed and miss the therapeutic window, resulting in a poor prognosis. The diagnosis of Clostridium perfringens liver abscess mainly depends on computed tomography (CT), needle aspiration, and/or blood culture. After diagnosis, treatments such as antibiotic therapy, surgical abscess drainage, blood transfusion as needed, and correction of metabolic disturbances must be immediately administered to prevent severe complications. Here, we present two cases of liver abscess due to Clostridium perfringens infection. Both patients initially presented only with fever, abdominal pain, and jaundice, symptoms that were easily confused with cholangitis caused by cholelithiasis. The patients then progressed rapidly and, despite receiving antimicrobial and multimodal sepsis treatment, both eventually died of multiple organ dysfunction syndrome. Clinicians should be on high alert for Clostridium perfringens liver abscesses disguised as biliary disease. Early diagnosis and treatment with the appropriate antibiotics and surgery are fundamental for the survival of the affected patients.
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Affiliation(s)
- Jialun Peng
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Qilong Zhai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Jinzheng Li
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Xingyu Chen
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Hongyu Wu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Tao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Gangyi Tang
- Department of General Surgery, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, People’s Republic of China
| | - Dajun Yu
- Department of General Surgery, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, People’s Republic of China
| | - Lixian He
- Department of General Surgery, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, People’s Republic of China
| | - Jinxu Li
- Department of General Surgery, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, People’s Republic of China
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Tohmatsu Y, Yamada M, Otsuka S, Ohgi K, Ashida R, Kurai H, Yasui H, Sugino T, Uesaka K, Sugiura T. Liver abscess caused by Clostridium perfringens after left hepatic trisectionectomy for perihilar cholangiocarcinoma: a case report. Surg Case Rep 2023; 9:111. [PMID: 37335427 DOI: 10.1186/s40792-023-01687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Clostridium perfringens sepsis has been reported to have a rapid onset and severe clinical outcome. We herein report a case of C. perfringens sepsis associated with massive intravascular hemolysis after left hepatic trisectionectomy for perihilar cholangiocarcinoma. CASE PRESENTATION A 72-year-old woman underwent left hepatic trisectionectomy for perihilar cholangiocarcinoma. Her postoperative course was uneventful except for bile leakage. She was discharged on postoperative day (POD) 35. On POD 54, she was readmitted because of abdominal pain with a high fever. Although her vital signs were stable on arrival at the hospital, a laboratory examination showed a severe inflammatory reaction and hemolysis, and she had developed disseminated intravascular coagulation. Abdominal contrast-enhanced computed tomography showed a 70-mm irregular shape and low-density containing air in liver segment 6, which suggested a liver abscess. The abscess was immediately drained of pus containing air. The pus showed multiple Gram-positive bacilli, and two blood cultures showed Gram-positive bacilli and hemolysis. Empirical antibiotic therapy with vancomycin and meropenem was started because C. perfringens was detected from the preoperative bile culture. Four hours after arrival, tachypnea and decreased oxygen saturation were observed. Her general condition deteriorated rapidly with significant hypoglycemia, progressive acidosis, anemia, and thrombocytopenia. Despite rapid drainage and empiric therapy, she died six hours after her arrival. At autopsy, the abscess consisted of coagulation necrosis of liver cells with inflammatory cell infiltration, and clusters of Gram-positive large bacilli were observed in the necrotic debris. C. perfringens was detected in the drainage fluid and blood culture. She was diagnosed with a liver abscess and severe sepsis caused by C. perfringens and treated promptly, but the disease progressed rapidly and led to her death. CONCLUSIONS Sepsis caused by C. perfringens can progress rapidly and lead to death in a few hours, so prompt treatment is needed. When patients who have undergone highly invasive hepatobiliary-pancreatic surgery show hemolysis and hepatic abscesses with gas, C. perfringens should be considered the most likely bacterium.
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Affiliation(s)
- Yuuko Tohmatsu
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Mihoko Yamada
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
| | - Shimpei Otsuka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Katsuhisa Ohgi
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Ryo Ashida
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Hanako Kurai
- Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan
| | - Haruna Yasui
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Katsuhiko Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Teiichi Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
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Olds KL, Gilbert JD, Byard RW. Unexpected Death Associated With Clostridial Sepsis. Am J Forensic Med Pathol 2021; 42:289-291. [PMID: 33394683 DOI: 10.1097/paf.0000000000000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT An 85-year-old woman with a history of breast carcinoma presented to hospital after gradual onset of abdominal pain with hypotension, jaundice, and massive intravascular hemolysis. This was caused by Clostridium perfringens septicemia originating from a liver abscess. Clostridium perfringens septicemia is a rare infection that has a high mortality rate, given that it is frequently unable to be diagnosed until postmortem examination. The source of the pathogen is usually intra-abdominal. Hepatic abscesses, although an uncommon source of primary clostridial infection, should be considered in such cases.
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Affiliation(s)
- Kelly L Olds
- From the School of Medicine, The University of Notre Dame Australia, Fremantle
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Dahl SS, Thorsteinsson M, Lambine TL, Penninga L. Severe sepsis caused by a gas-forming Clostridium perfringens and Klebsiella variicola liver abscess following total pancreatectomy. BMJ Case Rep 2020; 13:13/10/e238896. [PMID: 33012720 DOI: 10.1136/bcr-2020-238896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Stig Søgaard Dahl
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten Thorsteinsson
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Trine-Lise Lambine
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luit Penninga
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Hamura R, Haruki K, Kumagai Y, Shiba H, Wakiyama S, Yanaga K. Subphrenic abscess due to Clostridium perfringens after hepatic resection for hepatocellular carcinoma following emphysematous cholecystitis: Report of a case. Int J Surg Case Rep 2020; 67:86-90. [PMID: 32045859 PMCID: PMC7015821 DOI: 10.1016/j.ijscr.2020.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Subphrenic abscess caused by Clostridium perfringens is rare after hepatic resection. We herein report such a case after hepatic resection for hepatocellular carcinoma following treatment of emphysematous cholecystitis. CASE PRESENTATION A 69-years-old man with chronic hepatitis B, was admitted to our hospital for right subcostal pain and loss of appetite. Computed tomography (CT) revealed emphysematous cholecystitis, for which percutaneous transhepatic gallbladder drainage was performed. Clostridium perfringens was identified from the culture of the bile. Imaging studies immediately demonstrated hepatocellular carcinoma with right lobe of the liver, for which the patients underwent hepatic resection and cholecystectomy concomitantly. After operation, the patient developed emphysematous subphrenic abscess on postoperative day 15, for which CT-guided percutaneous drainage was performed. Clostridium perfringens was identified from the culture of the abscess fluid. The patient was given Ciprofloxacin and Clindamycin and made a satisfactory recovery. The patient was discharged on POD 95 and remains well with no evidence of tumor recurrence as of 8 years after resection. CONCLUSION We herein reported a subphrenic abscess due to Clostridium perfringens after hepatic resection for hepatocellular carcinoma following emphysematous cholecystitis.
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Affiliation(s)
- Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yu Kumagai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeki Wakiyama
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Abstract
Clostridium species are gram-positive, spore-forming, anaerobic rods normally found in the soil and gastrointestinal tract of humans and animals. Spontaneous sepsis due to C. perfringens is not caused by injury, which sets it apart from the classical gas gangrene that typically follows trauma. Spontaneous C. perfringens sepsis often develops as a rapidly progressive intravascular hemolysis and metabolic acidosis, with high mortality rates of over 70% with standard intensive care. In such cases, alpha toxin secreted by C. perfringens is considered the main toxin responsible for intravascular hemolysis, disseminated intravascular coagulopathy, and multiple organ failure. Theta-toxin causes a cytokine cascade, which results in peripheral vasodilation similar to that seen in septic shock. For C. perfringens infections, antibiotics, such as high-dose penicillin, and surgical drainage as early as possible are the principal treatments of choice. However, considering the current mortality rate of sepsis, outcomes have not improved with the current standard treatment for C. perfringens infections. Monoclonal antibody against theta toxin in combination with gas gangrene antitoxin presents a promising therapeutic option.
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Affiliation(s)
- Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital
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Kwon YK, Cheema FA, Maneckshana BT, Rochon C, Sheiner PA. Clostridium paraputrificum septicemia and liver abscess. World J Hepatol 2018; 10:388-395. [PMID: 29599902 PMCID: PMC5871859 DOI: 10.4254/wjh.v10.i3.388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/30/2018] [Accepted: 03/01/2018] [Indexed: 02/06/2023] Open
Abstract
We report the first case of a healthy 23-year-old female who underwent an interventional radiology-guided embolization of a hepatic adenoma, which resulted in a gas forming hepatic liver abscess and septicemia by Clostridium paraputrificum. A retrospective review of Clostridial liver abscesses was performed using a PubMed literature search, and we found 57 clostridial hepatic abscess cases. The two most commonly reported clostridial species are C. perfringens and C. septicum (64.9% and 17.5% respectively). C. perfringens cases carried a mortality of 67.6% with median survival of 11 h, and 70.2% of the C. perfringens cases experienced hemolysis. All C. septicum cases were found to have underlying liver malignancy at the time of the presentation with a mortality of only 30%. The remaining cases were caused by various Clostridium species, and this cohort’s clinical course was significantly milder when compared to the above C. perfringens and C. septicum cohorts.
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Affiliation(s)
- Yong K Kwon
- Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
| | - Faiqa A Cheema
- Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
| | - Bejon T Maneckshana
- Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
| | - Caroline Rochon
- Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
| | - Patricia A Sheiner
- Department of Transplant, Hartford Hospital, Hartford, CT 06106, United States
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Chukwu EE, Nwaokorie FO, Coker AO, Avila-Campos MJ, Ogunsola FT. Genetic variation among Clostridium perfringens isolated from food and faecal specimens in Lagos. Microb Pathog 2017; 111:232-237. [DOI: 10.1016/j.micpath.2017.08.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/30/2017] [Accepted: 08/30/2017] [Indexed: 11/27/2022]
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Wang M, Zhang X, Jiang T, Hu S, Yi Z, Zhou Y, Ming D, Chen S. Liver Abscess Caused by Pannonibacter phragmitetus: Case Report and Literature Review. Front Med (Lausanne) 2017; 4:48. [PMID: 28487855 PMCID: PMC5403815 DOI: 10.3389/fmed.2017.00048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 04/10/2017] [Indexed: 11/17/2022] Open
Abstract
Background Bacterial hepatic abscess is a common occurrence in developing countries, which is mostly caused by Klebsiella pneumoniae and Escherichia coli. Pannonibacter phragmitetus is a Gram-negative alkali-tolerant bacillus that exists in the natural environment. Human infection by this bacterium is rare, with only four cases reported. Method We presented one of these cases with a bacterial liver abscess by a polymicrobial infection involving P. phragmitetus and Streptococcus oralis, with P. phragmitetus being the predominate isolate. Result and discussion Our strain of P. phragmitetus was resistant to more antibiotics than the other reported two strains. This case further verified the infectivity of P. phragmitetus.
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Affiliation(s)
- Mingxi Wang
- Yun Leung Laboratory for Molecular Diagnostics, School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian, China.,Department of Medical Laboratory, Institute of Nanomedicine Technology, Weifang Medical University, Weifang, Shandong, China
| | - Xia Zhang
- Department of Medical Laboratory, Institute of Nanomedicine Technology, Weifang Medical University, Weifang, Shandong, China
| | - Tao Jiang
- Yun Leung Laboratory for Molecular Diagnostics, School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian, China
| | - Shaohua Hu
- Yun Leung Laboratory for Molecular Diagnostics, School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian, China
| | - Zhengjun Yi
- Department of Medical Laboratory, Institute of Nanomedicine Technology, Weifang Medical University, Weifang, Shandong, China
| | - Yajun Zhou
- Yun Leung Laboratory for Molecular Diagnostics, School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian, China
| | - Desong Ming
- Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Shicheng Chen
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, USA
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Eltawansy SA, Merchant C, Atluri P, Dwivedi S. Multi-organ failure secondary to a Clostridium perfringens gaseous liver abscess following a self-limited episode of acute gastroenteritis. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:182-6. [PMID: 25807198 PMCID: PMC4376230 DOI: 10.12659/ajcr.893046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Clostridium perfringens is an unusual pathogen responsible for the development of a gas-forming pyogenic liver abscess. Progression to septicemia with this infection has amplified case fatality rates. CASE REPORT We report a case of an 81-year-old lady with pyogenic liver abscess with gas formation that was preceded by an acute gastroenteritis. The most common precipitating factors are invasive procedures and immunosuppression. Clostridium perfringens was unexpectedly isolated in the drained abscess, as well as blood. It is a normal inhabitant of the human bowel and a common cause of food poisoning, notoriously leading to tissue necrosis and gas gangrene. CONCLUSIONS We report a case of gas-forming pyogenic liver abscess and bacteremia progressing to fatal septic shock, caused by an uncommon Clostridium perfringens isolate.
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Affiliation(s)
| | - Chandni Merchant
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA
| | - Paavani Atluri
- Department of Internal Medicine, Monmouth Medical Center,, Long Branch, NJ, USA
| | - Sukrut Dwivedi
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA
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A 71-year-old woman with recurrent falls and confusion. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2015; 25:321-2. [PMID: 25587294 PMCID: PMC4277160 DOI: 10.1155/2014/786547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Yang CC, Hsu PC, Chang HJ, Cheng CW, Lee MH. Clinical significance and outcomes of Clostridium perfringens bacteremia--a 10-year experience at a tertiary care hospital. Int J Infect Dis 2013; 17:e955-60. [PMID: 23578849 DOI: 10.1016/j.ijid.2013.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 02/19/2013] [Accepted: 03/19/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The mortality rate of patients with Clostridium perfringens bacteremia is 27-44%. Typically, the clinical characteristics of this infection are non-specific, which leads to considerable difficulty with the diagnosis and early initiation of appropriate therapy. METHODS A retrospective cohort study of patients who were hospitalized between August 2002 and July 2011 with C. perfringens bacteremia was conducted within a 3715-bed teaching hospital in northern Taiwan. The patients identified in this search were included when they had fever or other clinical features suggestive of systemic infection. Multiple logistic regression analysis was applied to determine the independent risk factors of 30-day mortality. RESULTS A total of 93 patients were identified. Elderly patients with comorbid illnesses, especially renal insufficiency or malignancy, were at risk of developing C. perfringens bacteremia, and 23 patients (24.7%) had nosocomial bacteremia. The 30-day and attributed mortalities were 26.9% (25/93) and 8.6% (8/93), respectively. Nosocomial infection was a significant predictor for mortality within 30 days (odds ratio 19.378, 95% confidence interval 2.12-176.99; p=0.009), independent of other disease parameters. Other independent risk factors included the Charlson weighted index of comorbidity, length of hospitalization, and stay in the intensive care unit. CONCLUSIONS Early recognition of this critical infection and early initiation of appropriate antibiotic treatment by surgical intervention or drainage is essential.
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Affiliation(s)
- Chien-Chang Yang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Shin Street, Gueishan, Taoyuan 333, Taiwan
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Lee SH, Kim HS, Kim SJ, Shin WG, Kim KH, Jang MK, Lee JH, Kim HY. [A case of Clostridium liver abscess with sepsis]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2013; 61:103-6. [PMID: 23458989 DOI: 10.4166/kjg.2013.61.2.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Clostridial septicemia usually occurrs in patients with immunocompromised diseases such as diabetes and malignancy. Clostridial liver abscess is very rare but highly fatal. We experienced a case of Clostridial septicemia due to liver abscess in a 73-year-old man. He was presented with fever and chills. On admission, abdominal CT scan showed about 35 mm sized hypoattenuated lesion with multiple central air-bubbles. After the diagnosis of liver abscess, the patient underwent prompt empirical antimicrobial therapy and percutaneous drainage. In spite of early therapy, the patient had gone into shock and death.
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Affiliation(s)
- Sang Ho Lee
- Digestive Disease Center, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Liver abscess due to Eikenella corrodens, Prevotella meloninogenica, and Lactobacillus spp. following pancreatoduodenectomy: Case report and review of the literature. Eur Surg 2010. [DOI: 10.1007/s10353-010-0508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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