A Rare Case of Clostridium sordellii Bacteremia in an Immunocompromised Patient

Matten, Jens; Buechner, Volker; Schwarz, Roman

doi:10.1007/s15010-008-8192-y

Cited by 11 publications

(13 citation statements)

References 10 publications

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“…Notable cases included a hospital-wide laboratory contamination,11 infection associated with colorectal carcinoma2 and infectious pericarditis 12. While it was not clear what the source of C. sordellii was in our patient, her neutropenia secondary to recent myelosuppressive chemotherapy was a likely risk factor.…”

Section: Discussionmentioning

confidence: 80%

“…In non-lethal infections with TcsL-positive C. sordellii , early treatment with culture-sensitive antimicrobials seems to be a major factor contributing to improved outcomes 7. Antibiotic resistance studies to date suggest that the many C. sordellii species are sensitive to penicillins, metronidazole and clindamycin 2 6. Treatment should include aggressive therapy for septic shock with volume resuscitation, hemodynamic support with vasopressors if required and early initiation of broad-spectrum antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…Clostridium sordellii infection, first reported in 1922,1 often presents clinically similar to toxic shock syndrome (TSS) and results in a 70% mortality rate 2. Morphologically, C. sordellii is a spore-forming anaerobic Gram-positive rod, commonly found in soil samples.…”

Section: Introductionmentioning

confidence: 99%

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Non-lethalClostridium sordelliibacteraemia in an immunocompromised patient with pleomorphic sarcoma

2016

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Clostridium sordellii is a spore-forming anaerobic Gram-positive rod that has rarely been reported to cause disease in humans. Resultant mortality from infection is estimated at nearly 70% and is most often correlated with gynaecological procedures, intravenous drug abuse or trauma. C. sordellii infection often presents similarly to toxic shock syndrome (TSS); notable features of infection include refractory hypotension, haemoconcentration and marked leucocytosis. Although clinically similar to TSS, a notable difference is C. sordellii infections rarely involve fever. The organism's major toxins include haemorrhagic (TcsH) and lethal factor (TcsL), which function to disrupt cytoskeletal integrity. Current literature suggests treating C. sordelli infection with a broad-spectrum penicillin, metronidazole and clindamycin. We present a case of C. sordellii bacteraemia and septic shock in an immunocompromised patient who was recently diagnosed with pleomorphic gluteal sarcoma. Despite presenting in critical condition, the patient improved after aggressive hemodynamic resuscitation, source control and intravenous antibiotic therapy.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Non-lethalClostridium sordelliibacteraemia in an immunocompromised patient with pleomorphic sarcoma

2016

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“…1 In the world literature, only very few cases of a toxic shock syndrome due to C. sordellii necrotizing infections have been reported till now. It has rarely been implicated as a human pathogen.…”

Section: Introductionmentioning

confidence: 99%

Clostridium sordellii Infection of Female Genital Tract: A Rare but Fulminating Reaction

Pathak¹,

Pathak²

2015

Journal of South Asian Federation of Obstetrics and Gynaecology

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Clostridium sordellii, an anaerobic pathogen, is ubiquitously distributed in the environment and causes fatal necrotizing infections in approximately 70% of all reported cases.Characteristic clinical features include absence of fever and rash, dramatic leukemoid reaction (LR), capillary leak and fluid sequestration with hemoconcentration, refractory tachycardia and hypotension, and marked edema of infected tissues without gas production or extensive myonecrosis. C. sordellii has rarely been identified in the genital tract, other Clostridium species colonize the vagina in 4 to 18% of healthy women and commonly are associated with postpartum endometritis and septic abortion. Pregnancy, childbirth, or abortion may predispose a some women to acquire C. sordellii in the vaginal tract. Dilatation of the cervix may lead to ascending infection of necrotic decidual tissue. The acidic pH of the vaginal tract may enhance the cytopathic effects of C. sordellii lethal toxin C. sordellii infections pose difficult clinical challenges and are usually fatal.

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“…These infections can be found in all ages. Underlying malignancy and being immunocompromised are aggravating risk factors (11,35,39,40). More rarely, C. sordellii infections can occur as small pseudo-outbreaks (41).…”

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confidence: 99%

Foot Infection by Clostridium sordellii: Case Report and Review of 15 Cases in France

et al. 2015

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dWe report a case of foot infection by Clostridium sordellii and review 15 human infections registered at a Reference Center in France during the period 1998 to 2011. All strains were found nontoxigenic, lacking the lethal toxin gene coding for TcsL. Like Clostridium septicum, several C. sordellii infections were associated with intestinal neoplasms. CASE REPORTA 78-year-old patient living alone under bad cognitive and hygienic conditions in a rural village of South of France was hospitalized for 4 days in August 2008 for confusion, major asthenia, and fever (38.2°C). Dehydration was marked, and diabetes mellitus and dyslipemia were discovered that necessitated insulin therapy. A burn on the foot (caused by exposure to boiling water) was colonized with a methicillin-resistant Staphylococcus aureus strain that necessitated only local treatment. Previous history was unremarkable, with treated arterial hypertension, episodes of painful constipation in 2005, acute epigastralgy 2 years before in 2006 with ultrasound echographic and nuclear magnetic resonance imaging (MRI), as well as endoscopic gastroscopy and Helicobacter pylori investigation all negative. Fifteen days later, the patient was admitted to the emergency ward with confusion, vertigo, fever (39°C), and abdominal pain beginning at the right hypocondrium and later at the epigastrium. There was neither shock (arterial tension of 17/7.2), nor were there pulmonary, urologic, clinical, or biological signs. Computed tomography scan examination revealed neither angiocholitis nor appendicitis. At the time of admission, there were 18,300 leukocytes/mm 3 , including 16,300 polymorphonuclear leukocytes (PMNs). The C-reactive protein level was slightly elevated (42 mg/liter, increasing 2 days later to 160 mg/liter). Coagulation was normal (prothrombin index, partial prothrombin time [PTT], and fibrinogen). Biochemistry was unremarkable (ionogram, glycemia, troponin, and pancreatic, muscular, and hepatic enzymes). Only renal clearance was slightly disturbed (60 ml/min/1.73 m 2 , as estimated by the Modification of Diet in Renal Disease [MDRD] Study equation), although in the same range as before, and more remarkably, the bilirubin level was elevated (24 mol/liter; normal, 2 to 22 mol/ liter): all bilirubin was constituted of free indirect bilirubin, meaning hemolysis. Bilirubinemia was normal (14 mol/liter) at the preceding hospitalization 3 weeks before. The patient had hemoconcentration (hemoglobin, 153 g/liter [usually 12 to 13 g/liter before and at late controls]; total proteins, 80 g/liter [usually around 65 g/liter]). Blood cultures were rapidly drawn, but the malleolar lesion, still present and now painful, was not sampled, and antibiotherapy started less than 3 h after admission, with metronidazole given at 500 mg three times a day (t.i.d.) and ceftriaxone given at 1 g/day. A Gram-positive spore-forming (subterminal or terminal spores) rod-shaped bacterium was evidenced within 11 h from anaerobic blood cultures (BacT/Alert FN; bioMérieux, Durham, NC). Colonies...

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A Rare Case of Clostridium sordellii Bacteremia in an Immunocompromised Patient

Cited by 11 publications

References 10 publications

Non-lethalClostridium sordelliibacteraemia in an immunocompromised patient with pleomorphic sarcoma

Non-lethalClostridium sordelliibacteraemia in an immunocompromised patient with pleomorphic sarcoma

Clostridium sordellii Infection of Female Genital Tract: A Rare but Fulminating Reaction

Foot Infection by Clostridium sordellii: Case Report and Review of 15 Cases in France

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