Clostridium perfringens empyema in a patient with metastatic squamous cell carcinoma of the lung

Oh, Daniel J.; Brecher, Stephen M.; Ruopp, Marcus D.

doi:10.4103/ijciis.ijciis_51_17

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Alternatively, Oh et al hypothesised that C. perfringens may be less virulent than other pathogens 1 7. Our patient presented with a slow indolent course of infection rather than a classical rapid necrotising infection.…”

Section: Discussionmentioning

confidence: 67%

“…In humans, this bacterium is commonly found in stool. Previous case reports have described C. perfringens empyema in patients with metastatic squamous cell carcinoma, penetrating trauma and cirrhosis 1–3. The empyema formation is poorly understood; however, possible causes include aspiration, direct seeding by trauma, instrumentation and bacterial translocation from the bowel leading to C. perfringens septicaemia 4…”

Section: Introductionmentioning

confidence: 99%

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Clostridium perfringensempyema after right hemicolectomy for caecal volvulus

Morocho,

Nikoleta,

Morocho

et al. 2023

BMJ Case Rep

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Empyema of the lung is an infection-induced collection of fluid in the chest cavity.Clostridium perfringensis a bacterium that inhabits the intestine and is a rare cause of empyema after abdominal surgery. A slow phase of infection, associated withC. perfringensempyema, has previously been reported in cases of similar infections. Herein, we present a case ofC. perfringensempyema following abdominal surgery. The empyema was initially managed using oxygen supplementation, fluid drainage and antibiotic therapy.This initial therapy failed in the present case because multiple collections of infected fluid prevented the lungs from expanding, requiring decortication, a pulmonary operation to remove the inflammatory tissue from the walls of the lung and associated with the infection, to allow the lung to expand. Following this operation, the patient recovered baseline levels of breathing and oxygen supplementation.

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Clostridium perfringensempyema after right hemicolectomy for caecal volvulus

Morocho,

Nikoleta,

Morocho

et al. 2023

BMJ Case Rep

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“… 3 In fact, only 4 cases have been reported in the English literature over the past 10 years. Among these studies, proposed etiologies included underlying lung malignancy, 4 , 5 cirrhosis complicated by hepatic hydrothorax, 6 and aspiration of oropharyngeal contents. 1 Other etiologies of pleuropulmonary infection from Clostridia bacteria previously reported included trauma or iatrogenic contamination of chest wall and pleural cavity, 1 , 7 chronic disease or immune system impairment, 6 , 8 pulmonary embolization and lung infarction, 9 and bacteremia from a secondary focus of infection.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Clostridium perfringens: Seeding beyond the gastrointestinal tract

Delungahawatta,

Rao,

Wolff

et al. 2024

Journal of Community Hospital Internal Medicine Perspectives

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Clostridia perfringens infection outside the gastrointestinal system is rare. Here, we report on a 75-year-old man with history of end-stage renal disease presenting after a syncopal event with lactic acidosis, leukocytosis, and mild hyper-bilirubinemia. Chest imaging revealed a loculated, left-sided pleural effusion; diagnostic thoracentesis identified Clostridia perfringens , consistent with an empyema. Video-assisted thoracic left lung decortication was performed; tissue culture also speciated Clostridia perfringens . Further imaging revealed concomitant acute cholecystitis, suggesting hematogenous seeding or transdiaphragmatic extension of Clostridia perfringens to pleural space from an abdominal source. The patient was successfully managed with laparoscopic cholecystectomy and discharged on a one-month course of amoxicillin-sulbactam. This case highlights the potential for Clostridia perfringens to produce a pleuropulmonary infection, necessitating timely diagnosis and intervention, to improve patient outcomes.

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