Necrotizing Clostridium subterminale infection with an odontogenic origin

Clostridium subterminale infection in a patient with diffuse large B-cell lymphoma and haemophagocytic syndrome: A case report and literature review

“… 15 Detection of C. subterminale, particularly in an immunocompromised patient, should trigger an immediate investigation into the potential source of the infection which may require surgical debridement and appropriate antibiotic coverage. 16 The patient in this present case was diagnosed with diffuse large B-cell lymphoma, a haematological malignancy that severely affects immunity and is a major risk factor for infection. In addition, the patient had a swollen left calf which could have also been the source of the infection.…”

“…However, although resistance to cephalosporins, clindamycin, aminoglycosides and quinolones has been reported, most Clostridium spp are sensitive to penicillin, carbapenems, glycopeptides and metronidazole. 14,16 In this present case, following identification of C. subterminale in blood culture, levofloxacin was initiated and used empirically to fight infection. After three days blood culture was negative for the bacilli and so demonstrated that the antibiotic treatment had been effective.…”

“… 11 We conducted a review of medical literature and found 13 articles that described 14 cases of infections caused by C. subterminale ( Table 1 ). 4 – 16 The cases were reported from 1975 to 2022. Of the 14 cases, seven (50%) were reported after 2011, suggesting that detection rate has increased significantly over the last decade.…”

“…Unsurprisingly, antibiotics were administrated in all cases, although susceptibility testing was only performed in two cases. 5 , 16 …”

“…Our literature search identified 13 articles that described 14 case studies ( Table 1 ). 4 – 16 The case study was approved by Ningbo First Hospital Ethics Committee (2021RS117) and signed informed consent was obtained from the patient for publishing his anonymised data. The reporting of this study conforms to CARE guidelines.…”