Direct detection of Clostridium sordellii in pleural fluid of a patient with pneumonic empyema by a broad-range 16S rRNA PCR

Abstract

We report the case of a 56-y-old male admitted with a left-sided post-pneumonic empyema. Clostridium sordellii DNA was directly detected in its pleural fluid by a broad-range 16S rRNA PCR, after 24 h of specimen collection. This is the third case of pleural infection caused by C. sordellii in the literature.

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

“…In the patient with pleural effusion the organism grew very slowly (15 days) in the anaerobic blood culture bottle. Anaerobic subcultures of the positive blood bottle showed spore forming gram-positive bacilli and DNA sequencing confirmed C. sordellii [38]. Thus, the use of broad-range 16S rRNA PCR in primary specimens can provide an organism specific diagnosis before culture results are available.…”

“…Although these patients appear to have had toxic shock, the portal of entry was not the reproductive tract and thus cannot be classified as gynecologic CSTS. Lastly, C. sordellii has been detected in a man with a brain abscess and another with empyema; each had a clinically protracted course but minimal evidence of systemic, toxin-mediated symptoms [37,38].…”

“…Broad-range 16S rRNA performed on extracted DNA from the from the original samples (brain abscess or pleural effusions) amplified a 440-460-bp DNA fragment that was sequenced and showed 99 to 100% similarity with C. sordellii sequences in GeneBank [37,38]. Lack of organism growth in the patient with a brain abscess was attributed to antibiotic treatment.…”

“…Needle aspirate of brain abscess material demonstrated pus but microorganisms were neither observed on Gram stain nor isolated; however, C. sordellii was found using broad-range 16S rRNA PCR in the original brain abscess specimen. The third patient was a man that presented with shortness of breath on exertion, fever, cough that produced blood stained sputum, pleuritic chest pain, and weight loss [38]. He received amoxicillinclavulanate empirically.…”

A Rare Case of Clostridium sordellii Bacteremia in an Immunocompromised Patient

“…Most of these patients died within hours to days after initial presentation [1]. Thus, infections with C. sordellii need to be diagnosed early, and patients should receive combined medical and surgical treatment [8]. The antibiotics of choice are penicillin, metronidazole, clindamycin, or the new broad-spectrum glycylcycline tigecycline.…”