Fulminant septic shock due to Clostridium perfringens skin and soft tissue infection eight years after liver transplantation

Juntermanns, Benjamin; Radünz, Sonia; Heuer, Matthias; Vernadakis, Spiridon; Reis, Henning; Gallinat, Anja; Treckmann, Jürgen; Kaiser, Gernot M.; Paul, Andreas; Saner, Fuat H.

doi:10.12659/aot.882009

Cited by 10 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Leuconostoc pseudomesenteroides is a rare bacterium that has been shown to originate from a bile leak in a liver transplant recipient following prolonged treatment with vancomycin [ 14 ]. Juntermanns et al described a case of a 55-year old man who died eight years after a liver transplantation after suffering from skin and soft tissue infections [ 15 ]. Earlier detection as well as earlier surgical and antibiotic interventions could have prevented the death of the patient [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Elizabethkingia Meningoseptica in a Case of Biliary Tract Infection Following Liver Transplantation

et al. 2017

View full text Add to dashboard Cite

Patient: Female, 55Final Diagnosis: Percutaneous transhepatic cholangiography biliary drain infection with Elizabethkingia meningosepticaSymptoms: Right upper quadrant abdominal painMedication: IV Ciprofloxacin 400 mg/12 hrsClinical Procedure: NoneSpecialty: Surgery and Internal MedicineObjective:Rare diseaseBackground:Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube.Case Report:A 55-year-old Saudi woman underwent liver transplantation. The post-operative period immediately following transplantation was complicated by anastomotic biliary stricture and bile leak, which was managed with percutaneous transhepatic cholangiography (PTC) with PTBD. She developed right upper quadrant abdominal pain, and her ultrasound (US) showed a sub-diaphragmatic collection. Microbial culture from the PTBD tube was positive for E. meningoseptica, which was treated with intravenous ciprofloxacin and metronidazole. This case is the second identified infection with E. meningoseptica at our specialist center, fifteen years after isolating the first case in a hemodialysis patient. We believe that this is the first case of E. meningoseptica infection to be reported in a liver transplant patient.Conclusions:The emerging nosocomial infectious organism, E. meningoseptica is being seen more often on hospital equipment and medical devices and in water. This case report highlights the need for awareness of this infection in hospitalized immunocompromised patients and the appropriate identification and management of infection with E. meningoseptica.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Juntermanns et al described a case of a 55-year old man who died eight years after a liver transplantation after suffering from skin and soft tissue infections [ 15 ]. Earlier detection as well as earlier surgical and antibiotic interventions could have prevented the death of the patient [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Elizabethkingia Meningoseptica in a Case of Biliary Tract Infection Following Liver Transplantation

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The abdominal pain has been strongly associated with a ruptured liver abscess. Once the bacteria are in blood stream, massive intravascular hemolysis occurs [ 20 – 22 ]. This can present as anemia on admission with evidence of hemolysis as indicated by low haptoglobin, high LDH, elevated indirect bilirubin, and spherocytosis [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Gas-Forming Pyogenic Liver Abscess with Septic Shock

Khan

Ishaq

Jones

2015

Case Reports in Critical Care

View full text Add to dashboard Cite

The pyogenic liver abscess caused by Clostridium perfringens (C. perfringens) is a rare but rapidly fatal infection. The main virulence factor of this pathogen is its α-toxin (lecithinase), which decomposes the phospholipid in cell membranes leading to cell lysis. Once the bacteria are in blood stream, massive intravascular hemolysis occurs. This can present as anemia on admission with evidence of hemolysis as indicated by low serum haptoglobin, high serum lactate dehydrogenase (LDH), elevated indirect bilirubin, and spherocytosis. The clinical course of C. perfringens septicemia is marked by rapidly deteriorating course with a mortality rate ranging from 70 to 100%. The very rapid clinical course makes it difficult to diagnose on time, and most cases are diagnosed at autopsy. Therefore it is important to consider C. perfringens infection in any severely ill patient with fever and evidence of hemolysis. We present a case of seventy-seven-year-old male with septic shock secondary to pyogenic liver abscess with a brief review of existing literature on C. perfringens.

show abstract

“…C perfringens has been implicated in causing a wide variety of clinical syndromes ranging from skin and soft tissue infections and gas gangrene, to gastroenteritis and enteritis necroticans ( 3 – 6 ).…”

Section: Discussionmentioning

confidence: 99%