Clostridium septicum and malignancy

Abstract

Background: Clostridium septicum is known to be associated with malignancy or immunosuppression. It has a variable clinical presentation and is associated with a high mortality. The aim of the present study was to review the experience at St George Hospital, Sydney, over a 10‐year period, with particular reference to the association of this condition with colorectal cancer. Methods: The records of five patients with blood culture‐proven Clostridium septicum infection, among a larger group of 31 patients with clostridial infections, presenting to St George Hospital between 1990 and 2000 were reviewed. Results: Associated malignancy was found in four (80%) of the patients with Clostridium septicum infection. Two infections were related to colorectal cancer, two to haematological malignancies and one to radiation‐induced recto‐urethral fistula. Those patients who had colorectal cancer presented with septicaemia and vague abdominal symptoms. Conclusions: Clostridium septicum infections have a strong association with malignancy. When this infection occurs without an obvious underlying aetiology there should be a high index of suspicion about associated malignancy. In the absence of haematol­ogical malignancy a colonoscopy is warranted. Early diagnosis and aggressive treatment is essential in order to improve prognosis.

„Spontaner“ Gasbrand mit Kompartmentsyndrom bei einem diabetischen Patienten

“…In den ver gan ge nen Jah ren wur den gehäuft spon ta ne Gas brand fäl le ohne er kennba res Trau ma im Sin ne en do ge ner In fektio nen be schrie ben, die über wie gend von Clostri di um sep ti cum ver ur sacht wur den [1,2,7,8]. Da die se In fek tio nen fast aus- …”

“…Clos trid i um sep ti cum · Spon ta ne ous gas gan grene · Atrau mat ic myo ne cro sis · Co lon can cer Spon ta ne ous gas gan grene in a di a bet ic pa tient with Clos trid i um sep ti cum schließ lich bei Pa ti en ten mit be stimm ten Grund er kran kun gen auf tre ten (bei spielswei se aku ter Leu kä mie, Ko lonkar zi nom, Dia be tes mel li tus, pe ri phe rer Ge fäßer krankung so wie zy kli scher Neu tro pe nie), sind sie -streng ge nom men -als op por tu nisti sche In fek tio nen an zu se hen, die häu fig als pa ra neo plas ti sches Syn drom weg weisend sind für noch un er kann te Ma lig nome [2,5,6,9]. > C.-sep ti cum-In fek tio nen sind als pa ra neo plas ti sches Syn drom weg wei send für noch un er kann te Ma lig no me…”

“…Bei Pa ti en ten mit Lä sio nen im Be reich des Ko lons hin ge gen kann Clostri di um septi cum häu fig aus Stuhl kul tu ren iso liert werden. Nek ro ti sie ren de En tero ko litiden, beispiels wei se im Rah men neu tro pe ni scher Zyk len bei Leuk ämi en und auch nek ro tisie ren de Ko lonkar zi no me be güns ti gen offen sicht lich die Ko lo ni sa ti on der Darm muko sa mit Clostri di um sep ti cum [2,5,8].…”

Intestinal Host-Microbiome Interactions

“…In addition to S. gallolyticus endocarditis, also Clostridium septicum infections have been clinically associated with sporadic CRC (Chew & Lubowski, 2001;Mirza et al, 2009). C. septicum is not considered to be part of the normal intestinal microbiota and is a rare cause of bacteremia (<1% of all cases).…”

Pore-Forming Activity of Alpha-Toxin Is Essential for Clostridium septicum -Mediated Myonecrosis

“…Disease in humans is primarily associated with colorectal cancer and hematological diseases (14), which presumably provide the predisposing conditions that allow the vegetative cells or spores to disseminate from the intestine and establish an infection (46). Disease progresses rapidly and is frequently fatal, with aggressive debridement of affected tissue in conjunction with antibiotic therapy being the only effective treatment option (27,28).…”