Clostridium perfringens sepsis complicated by right ventricular cardiogenic shock

Abstract

Clostridium perfringens sepsis has been ascribed a dismal prognosis when associated with massive intravascular haemolysis. We present a 71-year-old woman's fatal case which was compounded by isolated right ventricular cardiogenic shock. In this context, combined use of transthoracic echocardiography and pulmonary artery catheter monitoring is able to yield an individualized hemodynamic resuscitation. We discuss key aspects related to right and left heart mechanical efficiency, hypothesize as to the pulmonary hypertension mechanism of our case and set to emphasize a physiologically based framework for right ventricular failure hemodynamic management.

Septic Shock Due to Clostridium perfringens

“…Unfortunately, no randomized trials or evidence-based guidelines have defined a treatment regimen for clostridium toxic shock syndrome. The antibiotic regimens directed against Clostridium perfringens used in case series include penicillin four million units IV every four hours plus clindamycin 900 mg IV every eight hours [5,8,9]. Clindamycin, a bacteriostatic antibiotic, is often included in antibiotic regimens due to its ability to suppress toxin production.…”