Clostridium ramosum bacteremia: A case series at a general acute care hospital

Clostridium ramosum Bacteremia in an Immunocompetent Patient with SARS-CoV-2 Infection: A Case Report

“… 8 The source of the bacteremia was probably translocation from the gastrointestinal tract and soft tissue infections. 5 Moreover, the incidence of C. ramosum infections is likely underestimated, as Clostridium spp. may be unrecognized in cases of polymicrobial bacteremia due to its long incubation periods.…”

“… 4 Although C. ramosum can be isolated from clinical specimens, it is rarely identified as the primary cause of infection; therefore, its pathogenicity has been largely underestimated. 5 Infections caused by C. ramosum have been predominantly reported in young children (under 5 years old) with inner ear infections and immunocompromised elderly individuals. 6 However, in certain cases, C. ramosum has been reported to cause infections in healthy individuals.…”

“… 6 The predominant source of bloodstream infection is the translocation of strains from the digestive system to cutaneous decubitus. 5 Although rifampin resistance was discovered in 1971, tetracycline, aminoglycosides, and fluoroquinolone resistance were also noted; C. ramosum did not show multidrug resistance to most antimicrobial agents. 6 , 10 …”

“…6 The predominant source of bloodstream infection is the translocation of strains from the digestive system to cutaneous decubitus. 5 Although rifampin resistance was discovered in 1971, tetracycline, aminoglycosides, and fluoroquinolone resistance were also noted; C. ramosum did not show multidrug resistance to most antimicrobial agents. 6,10 Increasing evidence suggests that SARS-CoV-2 infection can compromise the integrity of the intestinal barrier by adversely affecting all layers of defense, including biological, mechanical, and immune barriers.…”

Clostridium ramosum Bacteremia With Mesenteric Ischemia Secondary to Superior and Inferior Mesenteric Arteries Occlusion

“…This species of Clostridium tends to be misidentified due to its gram-stain variability, the lack of visualization of spores, and the atypical morphology of its colonies. In the review of current C. ramosum literature, we came across 32 cases, most of the bacteremia in adults were elderly and immunocompromised with conditions including diabetes, excessive alcohol intake, liver cirrhosis, hematologic malignancies, and organic malignancies [1]. C. ramosum has also been reported to cause osteomyelitis, septic arthritis, mastoiditis, spondylodiscitis, otitis media, pyelonephritis, septic arterial emboli, endocarditis, gas gangrene, septic pseudoarthrosis, peritoneal dialysis-related peritonitis, liver abscess, brain abscess, cerebellar abscess, lung abscess, Fournier's gangrene, pseudomembranous colitis, infected thoracic aortic aneurysm and infection of intracranial hydatid cyst [2].…”