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Cirillo L, Noris A, Odone L, Giordano F, Becherucci F. Clostridium septicum infection complicating Hemolytic-Uremic Syndrome: a case report and review of the literature. J Nephrol 2024; 37:181-186. [PMID: 37314614 DOI: 10.1007/s40620-023-01641-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/03/2023] [Indexed: 06/15/2023]
Abstract
Clostridium septicum (C. septicum) is a zoonotic bacillus found in 2.8% of healthy human stools. In humans, it can cause serious infections such as bacteremia, myonecrosis, and encephalitis by spreading through the bloodstream. Reports of Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome complicated by C. septicum superinfection are rare, likely because colonic microangiopathic lesions by Shiga toxin-producing Escherichia Coli facilitate bacterial dissemination. Only 13 cases of Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome with C. septicum superinfection have been reported to date, according to our litterature review, with a 50% mortality rate. The lack of clinico-laboratory clues suggesting this condition makes the diagnosis challenging. For these reasons C. septicum superinfection usually goes undiagnosed in patients with Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome, and results in unfavorable outcomes. In this paper, we describe the case of a 5-year-old girl admitted for Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome who developed C. septicum coinfection leading to a fatal outcome. We carried out a review of the available literature on C. septicum infection complicating Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome and we compared the clinical features of the observed cases with those of an historical cohort of uncomplicated Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome. The mechanisms of superinfection are still unclear and clinical features are indistinguishable from those of uncomplicated Shiga toxin-producing Escherichia Coli-related hemolytic-uremic syndrome. However, rapid deterioration of clinical conditions and evidence of neurological involvement, associated with abnormal radiological findings, require immediate management. Although therapeutic approaches have not been directly compared, neurosurgical treatment of amenable lesions may improve the clinical outcome of patients with C. septicum-hemolytic-uremic syndrome.
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Affiliation(s)
- Luigi Cirillo
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Biochemical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Alice Noris
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Ludovica Odone
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Flavio Giordano
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Francesca Becherucci
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
- Department of Biochemical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy.
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Forga A, Robbins K, Smith A, Coles M, Tellez-Isaias G, Vuong CN, Hargis B, Graham D. Evaluation of Clostridium septicum hemolytic activity, administration route, and dosage volume of a clostridial dermatitis (cellulitis) bacterin-toxoid on humoral immune response in commercial turkeys. Poult Sci 2023; 102:102873. [PMID: 37390548 PMCID: PMC10466222 DOI: 10.1016/j.psj.2023.102873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 07/02/2023] Open
Abstract
Clostridial cellulitis or dermatitis affects commercial turkey flocks, primarily as they approach market age. In the field, this disease has been effectively controlled with antibiotics, but alternatives to antibiotics are needed. Bacterin-toxoid vaccination programs have been shown to prevent clostridial diseases in other species, including humans. Results from previous field studies indicate that vaccination with an experimental whole-cell Clostridium septicum (CS) bacterin-toxoid oil emulsion vaccine reduced clostridial dermatitis-associated mortality and antibiotic usage for some commercial turkey flocks, but vaccination was not always efficacious. To improve vaccine efficacy, studies were conducted to optimize the antigenic component of the experimental vaccine and to determine the appropriate antigen to adjuvant ratio, route, and volume for vaccine administration. It was determined that the phase of culture at time of formalin inactivation played a key role in serum antibody titer and larger volume vaccine doses produced higher serum antibody immune response regardless of antigen:adjuvant formulation ratio or route of injection. No significant differences (P > 0.05) were found between formulation ratios or between the subcutaneous and tail head injection sites. Based on these results, we propose to look further into the relationship between culture phase and antigenic components produced by CS under different culture conditions.
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Affiliation(s)
- Aaron Forga
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | | | | | - Makenly Coles
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | - Guillermo Tellez-Isaias
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | - Christine N Vuong
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | - Billy Hargis
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | - Danielle Graham
- Division of Agriculture, Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA.
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Du J, Meki I, Li Q, Liu Y, Zhu Z, Pan C, Xia Y, Fu L, Yang L, Zhang S, Yin C, Luo Y, Wang T, Liu B, Chen X. A non-toxic recombinant Clostridium septicum α toxin induces protective immunity in mice and rabbits. Toxicon 2023; 233:107234. [PMID: 37543293 DOI: 10.1016/j.toxicon.2023.107234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Abstract
Clostridium septicum alpha toxin (CSA) plays significant roles in ruminant's braxy. Genetically engineered CSA has been shown to function as a potential vaccine candidate in the prevention of the disease caused by Clostridium septicum. In the present study, we synthesized a non-toxic recombinant, rCSAm4/TMD by introducing four amino acid substitutions (C86L/N296A/H301A/W342A) and 11-amino-acid deletion (residues 212 to 222). Compared to recombinant CSA, rCSAm4/TMD showed no cytotoxicity to MDCK cells and was not fatal to mice. Moreover, rCSAm4/TMD could protect immunized mice against 5 × mouse LD100 (100% lethal dose) of crude CSA without obvious pathological change. Most importantly, rabbits immunized with rCSAm4/TMD produced high titers of neutralizing antibodies which protected the rabbits against crude CSA challenge. These data suggest that genetically detoxified rCSAm4/TMD is a potential subunit vaccine candidate against braxy.
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Affiliation(s)
- Jige Du
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Irene Meki
- International Atomic Energy Agency, Vienna, Austria
| | - Qianlin Li
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Ying Liu
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Zhen Zhu
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Chenfan Pan
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Yingju Xia
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Lizhi Fu
- Chongqing Academy of Animal Sciences, Chongqing, 402460, China
| | - Liu Yang
- Chongqing Academy of Animal Sciences, Chongqing, 402460, China
| | - Suhui Zhang
- Chongqing Academy of Animal Sciences, Chongqing, 402460, China
| | - Chunsheng Yin
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Yufeng Luo
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China
| | - Tuanjie Wang
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China.
| | - Bo Liu
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China; International Atomic Energy Agency, Vienna, Austria.
| | - Xiaoyun Chen
- China Institute of Veterinary Drug Control, Beijing, People's Republic of China.
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Slezak M, Smolar M, Drobna Saniova B, Hosala M, Miklusica J. Clostridium septicum foot gangrene associated with colorectal cancer. Neuro Endocrinol Lett 2022; 43:57-64. [PMID: 35490422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Since the second half of the 20th century, an association between the occurrence of Clostridium septicum and Streptococcus gallolyticus infections in patients with colorectal cancer has been described in specialist literature. Infections are manifested by bacteremia, septic embolism, cellulitis, myonecrosis, and gas gangrene of the limbs. MATERIAL AND METHODS The authors present a case of a rare association between lower limb gangrene caused by the septic embolization of a Clostridium septicum infection and malignancy of colon ascendens in a polymorbid patient. Gangrene of the lower limb led to septic shock requiring acute amputation treatment. After managing the acute condition, the patient was operated on for a malignant colon tumour. DISCUSSION The process of carcinogenesis often takes years and is almost asymptomatic. The occurrence of S. bovis/S. equinus (SBSEC) and C. septicum bacteremia, respectively, is relatively rare, but their presence is often associated with the occurrence of malignancy, most often of the lower gastrointestinal tract. This paraneoplastic symptom may be the first manifestation of a malignant disease. The effect of exotoxins can lead to sepsis or even septic shock with a mortality of 48-56%. CONCLUSION Clostridium septicum and Streptococcus gallolyticus infections are rare in clinical practice. However, their presence can be a first paraneoplastic symptom, and therefore the doctor should look for a possible oncological disease when they are detected. The main diagnostic methods include colonoscopy and imaging, especially CT scan.
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Affiliation(s)
- Miroslav Slezak
- Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Marek Smolar
- Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Beata Drobna Saniova
- Clinic of Anaesthesiology and Intensive medicine, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital, Martin, Slovak Republic
| | - Michal Hosala
- Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Juraj Miklusica
- Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
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Ghanouni A, Avila SA, Kim HJ. Occult Colon Adenocarcinoma and Multiple Myeloma Associated With Clostridium septicum Panophthalmitis With Orbital and Chiasmal Extension: A Case Report. Ophthalmic Plast Reconstr Surg 2022; 38:e6-e10. [PMID: 34593715 DOI: 10.1097/iop.0000000000002056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A previously healthy 62-year-old African American female presented with a fulminant orbital cellulitis of the right eye with diffuse scleritis and orbital inflammation extending to the optic chiasm on neuroimaging. She was taken for an emergent orbitotomy with an orbital fat biopsy and started on broad-spectrum intravenous (IV) and topical antibiotics. Within 36 hours of presentation, scleral thinning and a corneal melt ensued, ending in enucleation. Intraoperative cultures were positive for Clostridium septicum, leading to a systemic work-up exposing a previously undiagnosed colon adenocarcinoma and metastatic multiple myeloma.
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Affiliation(s)
- Arian Ghanouni
- Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Sarah A Avila
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - H Joon Kim
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
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Affiliation(s)
- Masataka Kudo
- Department of General Internal Medicine, Aso Iizuka Hospital, Japan
| | - Takayuki Uchida
- Department of Cardiovascular Surgery, Aso Iizuka Hospital, Japan
| | | | - Takashi Matono
- Department of Infectious Diseases, Aso Iizuka Hospital, Japan
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Behr-Gross ME, Siklodi B, Le Tallec D, Halder M, Manou I, Sinitskaya N, Bruckner L, Dalmadi B, Kiss L, Redhead K. Collaborative study for the validation of cell line assays for in-process toxicity and antigenicity testing of Clostridium septicum vaccine antigens - Part 2: Optimisation of cell line assays. Pharmeur Bio Sci Notes 2021; 2021:101-156. [PMID: 34078535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
During the production of clostridial vaccines large numbers of mice are used for various in-process control tests. Replacement in vitro assays had been developed for the testing of the toxins and toxoids of several clostridial species, but none of these assays had been assessed in an international collaborative study. Under the common aegis of the European Partnership for Alternative Approaches to Animal Testing (EPAA) and of the European Directorate for the Quality of Medicines & HealthCare (EDQM), a project on clostridial vaccines for veterinary use was started as part of the EDQM-co-ordinated Biological Standardisation Programme (BSP). Within the framework of this project (coded BSP130) a collaborative study was organised to evaluate Vero cell-based alternative methods to the current mouse tests used to measure: i) the toxicity of Clostridium septicum toxin, ii) the absence of toxicity of C. septicum toxoid and iii) the antigenicity of C. septicum toxoid. The principal aims of the study were to determine the repeatability and reproducibility of the in vitro assays and to demonstrate concordance of the in vitro and current in vivo tests. The study results demonstrated good concordance, but the information gathered through the study (later on called Part 1) and the participants' workshop prompted the extension of the project in order to further optimise the in vitro protocols and improve their repeatability and reproducibility, which were comparable to but not better than those of the in vivo assays in Part 1. The 3 in vitro assays to be optimised in the extension of the BSP130 project were : i) the in vitro toxin neutralisation equivalence plus (TNE+), as a replacement for the in vivo minimum lethal dose (MLD) test for quantification of the toxicity of toxin; ii) the in vitro MLD, as a replacement for the in vivo MLD test for detection of residual toxicity associated with toxoid; iii) the in vitro total combining power (TCP), as a replacement for the in vivo TCP test for quantification of the antigenicity of toxoid. At this point, the Analytical Method Transfer Laboratory of Ceva-Phylaxia (Hungary), supported by the project management team, developed suitable SOPs for the 3 in vitro assays. These optimised methods were further assessed in BSP130 through a second international collaborative study (Part 2) aimed at defining repeatability and reproducibility in different laboratories and determining the levels of improvement compared with the original in vivo tests and the initial in vitro assays used in Part 1 of the project. Fourteen laboratories, comprising 4 public sector and 10 manufacturers' medicines control laboratories, from 11 countries participated in the collaborative Part 2 study, each testing 6 different C. septicum toxins and 6 C. septicum toxoids. Improved repeatability and reproducibility were observed for the optimised assays. The results of this study confirm the suitability of these assays for in-process control of C. septicum vaccines, with better repeatability and reproducibility than their in vivo equivalents. It is expected that, with appropriate minor changes and the use of relevant reagents, these optimised in vitro assays could be used not only for the assessment of C. septicum toxins and toxoids but for all cytotoxin-based clostridial antigens. The development and implementation of such in vitro assays would offer a great opportunity to significantly reduce animal usage, shorten the duration of QC test procedures and increase the precision of toxicity and antigenicity assays in clostridial veterinary vaccine in-process control. This would also provide more accurate and reproducible dosing of antigens in the final vaccine products, help to promote compendial acceptance and to proffer a basis for improved international harmonisation across this area of product testing.
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Affiliation(s)
- M-E Behr-Gross
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network & Healthcare (DBO), Council of Europe, Strasbourg, France
| | - B Siklodi
- Ceva-Phylaxia, Veterinary Biologicals Co. Ltd, Hungary
| | - D Le Tallec
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network & HealthCare (DBO), Council of Europe, Strasbourg, France
| | - M Halder
- European Commission, Joint Research Centre, Via E. Fermi, 2749, 21027 Ispra (VA), Italy
| | - I Manou
- European Partnership for Alternative Approaches to Animal Testing (EPAA), Brussels, Belgium
| | - N Sinitskaya
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network & HealthCare (DBO), Council of Europe, Strasbourg, France
| | | | - B Dalmadi
- Ceva-Phylaxia, Veterinary Biologicals Co. Ltd, Hungary
| | - L Kiss
- Ceva-Phylaxia, Veterinary Biologicals Co. Ltd, Hungary
| | - K Redhead
- Vaccine & Assay Consultancy, Watford, WD25 0EX, United Kingdom
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Jerrari R, Jayet J. Mycotic Aneurysm Rupture Due to Clostridium septicum Thoracic Aortitis. Eur J Vasc Endovasc Surg 2020; 61:421. [PMID: 33208291 DOI: 10.1016/j.ejvs.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Reda Jerrari
- Hopital Universitaire Pitie Salpetriere, Boulogne Billancourt, France
| | - Jérémie Jayet
- Hopital Universitaire Pitie Salpetriere, Boulogne Billancourt, France.
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Saiyed A, Datta D. A Middle-Aged Woman With Hematochezia, Hypotension, and Leg Cramps. Chest 2020; 158:e21-e24. [PMID: 32654734 DOI: 10.1016/j.chest.2020.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/04/2020] [Accepted: 02/19/2020] [Indexed: 11/18/2022] Open
Abstract
CASE PRESENTATION A 57-year-old woman with a history of mantle cell lymphoma presented to the ED with complaints of vomiting, bleeding per rectum, and leg cramps, that started 6 h prior to her arrival. She had received chemotherapy a week prior. Her leg cramps were not associated with pain or swelling of the legs; she also denied any trauma to the legs. She did complain of mild lower abdominal pain at presentation. Review of systems was negative for fever, chills, diarrhea, chest pain, and dizziness. She denied using alcohol or nonsteroidal anti-inflammatory drugs. The patient was tachycardic with a systolic BP (SBP) of 85 mm Hg and was administered 1-L normal saline, with improvement in her SBP to 90 mm Hg. The hematocrit level was 24%, the WBC count was 0.3 × 109/L, and the platelet count was 6 × 109/L in the ED. On arrival in the ICU, she was noted to have an SBP of 70 mm Hg. Resuscitation with IV fluids was initiated, followed by transfusion of packed RBCs and platelets, based on the blood counts. Despite aggressive fluid resuscitation and improvement in her hemoglobin, the patient remained persistently hypotensive. The diagnosis of underlying septic shock because of neutropenia was considered; the patient was started on vasopressors and empirical broad-spectrum antibiotics, with improvement in her BP. After this, the patient was sent to radiology for a CT scan of the abdomen and pelvis with contrast to evaluate for mesenteric infarction, enteric or colonic bleeding, and the need for arterial embolization.
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Affiliation(s)
- Alifaiz Saiyed
- Department of Internal Medicine, University of CT Health Center, Farmington, CT
| | - Debapriya Datta
- Division of Pulmonary & Critical Care Medicine, University of CT Health Center, Farmington, CT.
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Zheng W, Li S, Chen F, Ke J. Pneumorrhachis: an imaging hint of Clostridium septicum infection. Intensive Care Med 2019; 46:1275-1277. [PMID: 31713640 DOI: 10.1007/s00134-019-05852-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/01/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Wuhong Zheng
- Department of Emergency, Fujian Provincial Hospital, Provincial Clinical Medical College, Fujian Medical University, 134 East Street, Fuzhou, 350001, Fujian, People's Republic of China
- Fujian Provincial Institute of Emergency Medicine, Fuzhou, Fujian, People's Republic of China
- Fujian Emergency Medical Center, Fuzhou, Fujian, People's Republic of China
| | - Shifeng Li
- Department of Emergency, Fujian Provincial Hospital, Provincial Clinical Medical College, Fujian Medical University, 134 East Street, Fuzhou, 350001, Fujian, People's Republic of China
- Fujian Provincial Institute of Emergency Medicine, Fuzhou, Fujian, People's Republic of China
- Fujian Emergency Medical Center, Fuzhou, Fujian, People's Republic of China
| | - Feng Chen
- Department of Emergency, Fujian Provincial Hospital, Provincial Clinical Medical College, Fujian Medical University, 134 East Street, Fuzhou, 350001, Fujian, People's Republic of China.
- Fujian Provincial Institute of Emergency Medicine, Fuzhou, Fujian, People's Republic of China.
- Fujian Emergency Medical Center, Fuzhou, Fujian, People's Republic of China.
| | - Jun Ke
- Department of Emergency, Fujian Provincial Hospital, Provincial Clinical Medical College, Fujian Medical University, 134 East Street, Fuzhou, 350001, Fujian, People's Republic of China.
- Fujian Provincial Institute of Emergency Medicine, Fuzhou, Fujian, People's Republic of China.
- Fujian Emergency Medical Center, Fuzhou, Fujian, People's Republic of China.
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Makarawo TP, Shea J, Smithson L. Necrotizing myonecrosis secondary to hematogenous spread of gas gangrene following colonic perforation. Int J Colorectal Dis 2016; 31:157-8. [PMID: 25787163 DOI: 10.1007/s00384-015-2185-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Tafadzwa P Makarawo
- Department of Surgery, Providence Hospital and Medical Center, 16001 W Nine Mile Road, Southfield, MI, 48075, USA.
| | - John Shea
- Department of Surgery, Providence Hospital and Medical Center, 16001 W Nine Mile Road, Southfield, MI, 48075, USA
| | - Lauren Smithson
- Department of Surgery, Providence Hospital and Medical Center, 16001 W Nine Mile Road, Southfield, MI, 48075, USA
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Yavuzcan A, Cağlar M, Dilbaz S, Kumru S, Avcioğlu F, Ustün Y. Identification of Clostridium septicum in a tubo-ovarian abscess: a rare case and review of the literature. VOJNOSANIT PREGL 2014; 71:884-888. [PMID: 25282789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Tubo-ovarian abscess (TOA) is a conglomerated mass of pelvic organs including the tube, the ovary, and the bowel. The most commonly isolated organisms from TOAs are Escherichia coli (E. coli) and Bacteroides species. CASE REPORT We reported a case of Clostridium septicum (C. septicum) infection from a ruptured TOA with atypical clinical features. Culture of intra-abdominal free fluid obtained during surgery yielded C. septicum. VITEK II (bioMérieux, France) automated system was used for advanced identification of the bacteria. Parenteral clindamycin in combination with an aminoglycoside was used. The patient was discharged 19 days after the surgery and was clinically asymptomatic 6 months after the surgery. CONCLUSION The differential diagnosis of TOA caused by C. septicum can be difficult, due to the lack of the symptoms. Tissues infected with C. septicum can become necrotic. A combination of early, adequate antibiotic therapy and surgery is the key point of the treatment.
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Abstract
Clostridium septicum infection following hemolytic uremic syndrome is rare and carries a poor prognosis, especially when the brain is involved. We report a case of a previously healthy 2-year-old boy who presented with two days of anuria and bloody diarrhea. He was admitted to the local children's hospital with a diagnosis of hemolytic uremic syndrome, presumably secondary to E. coli O157. He soon required intubation and was noted to have fixed and dilated pupils. Head CT revealed left frontal subcortical white matter vasogenic edema and scattered pockets of pneumocephalus. The patient expired 14 hours after admission. Antemortem blood cultures grew C. septicum. Gross pathologic examination of the brain revealed a large intraparenchymal cerebral hemorrhage in the left frontal and parietal lobes. There was extensive cystic changes as well. Microscopic examination revealed vacuolization and diffuse colonization with rod-shaped bacteria, but without the expected tissue response. There have been only six previously reported cases of C. septicum infection following hemolytic uremic syndrome, four of which had brain involvement. Mortality rate is high, with the only known survivor among those with brain involvement having a brain abscess rather than diffuse pneumocephalus.
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Dedemadi G, Sakellariou I, Kolinioti A, Lazaridis P, Anagnostou E. Clostridium septicum myonecrosis: a destructive and lethal condition. Am Surg 2011; 77:e101-e102. [PMID: 21679616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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COULTHARD CE, CHANTRILL BH. A Sterility Test for Neoarsphenamine B.P.: The Survival of Bacterial Spores in Arsphenamines. J Pharm Pharmacol 2011; 4:373-4. [PMID: 14946683 DOI: 10.1111/j.2042-7158.1952.tb13160.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Testa A, Giannuzzi R, de Gaetano Donati K, Gentiloni Silveri N. Fulminant endogenous gas gangrene: role of ultrasonography in the emergency setting. Am J Emerg Med 2010; 28:643.e1-3. [PMID: 20579573 DOI: 10.1016/j.ajem.2009.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Accepted: 09/04/2009] [Indexed: 11/19/2022] Open
Affiliation(s)
- Americo Testa
- Department of Emergency Medicine, A Gemelli University Hospital, 00168 Rome, Italy.
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Chang YJ, Wu CT, Chiu CH, Hsia SH, Huang CS. Fulminant Clostridium septicum infection mimicking appendicitis in a healthy child. Ann Trop Paediatr 2007; 27:91-4. [PMID: 17469739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A 5-year-old boy with Clostridium septicum enterocolitis presented with severe right lower abdominal pain. On the day after admission, shock, neutropenia and pneumoperitoneum prompted a laparotomy. Gangrene of the ileum and colon was identified, associated with a fatal Clostridium septicum infection.
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Affiliation(s)
- Yi-Jung Chang
- Division of Paediatric Critical Care and Emergency Medicine, Department of Paediatics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tauyuan, Taiwan
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Gegúndez Gómez C, Monjero Ares MI, Cao Pena J, Costa Buján JA, Conde Vales J, Arija Val JF. Mionecrosis por Clostridium como complicación de hernioplastia inguinal. Cir Esp 2007; 81:99-101. [PMID: 17306127 DOI: 10.1016/s0009-739x(07)71272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Clostridial myonecrosis is a necrotizing soft tissue infection characterized by muscular necrosis and, by extension, that of the surrounding tissue. If this infection develops quickly, it can cause septic shock and death if treatment is delayed. This infection does not occur frequently in civil medicine but nor is it exceptional after traumatic injuries or as a septic infection resulting from certain surgical interventions. Spontaneous development of clostridial myonecrosis is not uncommon (most commonly produced by the Clostridium septicum genus), propagated mainly from the colon in patients with neoplasia and in poor health. Consequently, in patients of bacteremia caused by C. septicum, colonic tumor must be ruled out. We present a new case of C. septicum myonecrosis of the abdominal after elective inguinal hernia repair.
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Affiliation(s)
- Carlos Gegúndez Gómez
- Servicio de Cirugía General y Aparato Digestivo, Complexo Hospitalario Xeral-Calde, Lugo, España.
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BATTY I, WALKER PD. Differentiation of Clostridium septicum and Clostridium chauvoei by the use of fluorescent labelled antibodies. ACTA ACUST UNITED AC 1998; 85:517-21. [PMID: 13966870 DOI: 10.1002/path.1700850232] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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MORIN M, FREDETTE V. [A TRIGGERING FACTOR IN CLOSTRIDIUM SEPTICUM GAS GANGRENE]. Ann Inst Pasteur (Paris) 1964; 106:315-9. [PMID: 14137371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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FREI W, STUENZI H, ALMASY F. [ON LIVER LIPIDS IN GUINEA PIGS. 3. THE TOTAL LIPID, NEUTRAL FAT, PHOSPHATIDE, CHOLESTEROL, FAT-FREE DRY SUBSTANCE AND WATER CONTENT OF THE LIVER IN CLOSTRIDIUM SEPTICUM-INFECTED GUINEA PIGS]. Helv Physiol Pharmacol Acta 1963; 21:312-8. [PMID: 14107836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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REY CALERO J. [Experimental inoculation of the chick embryo with Clostridium septicum]. Hisp Med 1962; 19:35-7. [PMID: 14491667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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BLAGOVESHCHENSKII VA, MAIOROVA IP. [Adsorption and elution of an active protein in Vibrio septicus anatoxin]. Biokhimiia 1959; 24:566-70. [PMID: 13671024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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PENSO G, VICARI G. [Study of immunological phenomena by means of tissue culture. V. Cytopathogenic effects of Clostridium septicum toxin]. Rend Ist Sup Sanit 1959; 22:135-7. [PMID: 13658454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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HALBERT SP, KAZAR CS, SWICK L. Mixed bacterial infections in relation to antibiotic activities. II. The role of staphylococcal antibiotic in a Clostridium septicum-Staphylococcus albus infection. Antibiot Chemother (Northfield) 1957; 7:235-242. [PMID: 24544423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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PREVOT AR, LEVADITI J, TARDIEUX P. [Bovine enzootic fulminating necrotic hepatitis due to association of Welchia perfingens and Clostridium septicum]. C R Hebd Seances Acad Sci 1956; 242:1544-7. [PMID: 13317177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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HALBERT SP, SONN C, SWICK L. Mixed bacterial infections in relation to antibiotic activities. I. Clostridium septicum-Micrococcus infections. J Immunol 1954; 73:169-79. [PMID: 13201758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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TAYLOR WI. The effect of antibiotics on spores of Clostridium septicum in vivo. Antibiot Chemother (Northfield) 1954; 4:673-677. [PMID: 24543102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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TERRACOL J, BERTRAND L, ROUX J. [Symptomatic anthrax of the face due to Vibrio septicus]. Presse Med (1893) 1954; 62:127-8. [PMID: 13145545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
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GUILLAUMIE M, KREGUER A. [New researches on the evaluation of the anti-histolyticum and anti-septicum activity of different sera]. Ann Inst Pasteur (Paris) 1954; 86:38-52. [PMID: 13158926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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GUILLAUMIE M, KREGUER A, GEOFFROY M, READE G. [Studies on the properties of Clostridium histolyticum and Clostridium septicum antisera]. Ann Inst Pasteur (Paris) 1953; 84:517-28. [PMID: 13124941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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GUILLAUMIE M, KREGUER A, GEOFFROY M, READE G. [Antigens common to the toxins of Clostridium septicum and histolyticum]. C R Hebd Seances Acad Sci 1953; 236:429-32. [PMID: 13033375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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TAYLOR W, NOVAK M. Antibiotic prophylaxis of experimental clostridial infections. II. Penicillin prophylaxis of Clostridium perfringens and Clostridium septicum infections. Antibiot Chemother (Northfield) 1952; 2:576-580. [PMID: 24542145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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DAFAALLA EN, SOLTYS MA. Studies on agglutination of red cells by clostridia. I. Cl. septique. Br J Exp Pathol 1951; 32:510-5. [PMID: 14895790 PMCID: PMC2073172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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EADS CH, LOWBEER L. Case report of sudden death [multiple clostridium septicum emboli in intrahepatic portal veins, with extensive necrosis of the liver]. Proc Staff Meet Tulsa Okla Hillcrest Meml Hosp 1947; 4:133-141. [PMID: 18906905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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BERNHEIMER AW. Immunization with Clostridium septicum toxoid and with trivalent gas gangrene toxoid. J Immunol 1947; 56:317-321. [PMID: 20261077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Affiliation(s)
- F J Ryan
- Department of Zoology, Columbia University, New York 27, New York
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