Neuromuscular and Central Nervous System Manifestations of Clostridium perfringens Infections

Finsterer, Josef; Hess, Bryan

doi:10.1007/s15010-007-6345-z

Cited by 35 publications

(33 citation statements)

References 98 publications

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“…This anaerobe affects humans and animals, producing severe diseases, including food poisoning (4), gastrointestinal syndromes and enterotoxemias (3,5,6), gas gangrene, and numerous histotoxic infections (7)(8)(9). With the exception of food poisoning caused by C. perfringens enterotoxin (CPE), a common characteristic in most toxigenic C. perfringens vegetative infections is the rapid progression of the disease to a final, often fatal, outcome.…”

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confidence: 99%

The CpAL Quorum Sensing System Regulates Production of Hemolysins CPA and PFO To Build Clostridium perfringens Biofilms

2015

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Mexico bClostridium perfringens strains produce severe diseases, including myonecrosis and enteritis necroticans, in humans and animals. Diseases are mediated by the production of potent toxins that often damage the site of infection, e.g., skin epithelium during myonecrosis. In planktonic cultures, the regulation of important toxins, such as CPA, CPB, and PFO, is controlled by the C. perfringens Agr-like (CpAL) quorum sensing (QS) system. Strains also encode a functional LuxS/AI-2 system. Although C. perfringens strains form biofilm-like structures, the regulation of biofilm formation is poorly understood. Therefore, our studies investigated the role of CpAL and LuxS/AI-2 QS systems and of QS-regulated factors in controlling the formation of biofilms. We first demonstrate that biofilm production by reference strains differs depending on the culture medium. Increased biomass correlated with the presence of extracellular DNA in the supernatant, which was released by lysis of a fraction of the biofilm population and planktonic cells. Whereas ⌬agrB mutant strains were not able to produce biofilms, a ⌬luxS mutant produced wild-type levels. The transcript levels of CpAL-regulated cpa and pfoA genes, but not cpb, were upregulated in biofilms compared to planktonic cultures. Accordingly, ⌬cpa and ⌬pfoA mutants, in type A (S13) or type C (CN3685) backgrounds, were unable to produce biofilms, whereas CN3685⌬cpb made wild-type levels. Biofilm formation was restored in complemented ⌬cpa/cpa and ⌬pfoA/ pfoA strains. Confocal microscopy studies further detected CPA partially colocalizing with eDNA on the biofilm structure. Thus, CpAL regulates biofilm formation in C. perfringens by increasing levels of certain toxins required to build biofilms.

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confidence: 99%

The CpAL Quorum Sensing System Regulates Production of Hemolysins CPA and PFO To Build Clostridium perfringens Biofilms

2015

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“…Subdural empyema and diffuse encephalitis with C. perfringens are reported to be fulminant and have a fatal outcome in 30 to 100% of untreated patients (9). The functional recovery in our patient might be explained by the early targeted therapy with penicillin and metronidazole.…”

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confidence: 61%

“…If local infections spread via hematogenous dissemination, every organ might be involved, including the brain. Central nervous system manifestation of C. perfringens infection in humans is rare (9). Most commonly, the meninges are affected (1, 3, 6, 7, 10-14, 16-19, 21, 22, 23-25, 29, 30) after clinical manifestation of sepsis (31).…”

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confidence: 99%

Meningoencephalitis with Subdural Empyema Caused by Toxigenic Clostridium perfringens Type A

Hugelshofer¹,

Achermann²,

Kovari³

et al. 2012

J Clin Microbiol

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cWe report a clinical case of meningoencephalitis with subdural empyema in an immunocompromised farmer caused by toxigenic Clostridium perfringens type A, which was identified by 16S RNA gene analysis of cerebrospinal fluid and subdural empyema. In immunocompromised patients, C. perfringens should be considered a potential pathogen of sepsis. CASE REPORT In June 2011, a 74-year-old farmer developed headache, fever, nausea with emesis, and fatigue within 24 h prior to admission to a community hospital. Due to a systemic inflammatory response syndrome (SIRS), he was referred to the intensive care unit (ICU). Empirical intravenous antibiotic treatment with piperacillin-tazobactam and clarithromycin was started based on the clinical presentation of pneumonia with a suspicious infiltrate in the basal lobe. The patient was immunosuppressed secondary to unclassified myelodysplastic syndrome (MDS) and was on continuous steroid treatment for bronchiolitis obliterans organizing pneumonia. Three weeks prior to hospital admission, the farmer had been struck by a cow, but did not seek medical attention. Two hours after admission, the patient developed a generalized seizure with postictal reduced consciousness and left-sided Todd's paresis. A cerebral computed tomography (CT) showed a thin hypodense subdural parieto-occipital lesion on the right side with adjacent brain edema, suggestive of a chronic subdural hematoma (Fig. 1a). Therefore, the patient was referred to a tertiary care hospital for neurosurgical intervention. There, in addition to fever and tachycardia, reduced consciousness, left-sided hemiparesis, and slight neck stiffness were present. The laboratory findings revealed the following: white blood cell count, 1.02 ϫ 10 6 /ml (34% neutrophils, 63% lymphocytes, 1% eosinophils, and 2% monocytes); thrombocyte count, 23 ϫ 10 6 /ml; prothrombin ratio, 58%; international normalized ratio (INR), 1.3; serum C-reactive protein, 13.3 mg/dl; and HIV and hepatitis B negative. Based on clinical presentation with headache, fever, epileptic seizure, and slight neck stiffness, a central nervous system (CNS) infection was postulated. Antibiotic treatment was changed to intravenous ceftriaxone, amoxicillin, metronidazole, vancomycin, and acyclovir in order to cover microorganisms potentially causing central nervous system (CNS) infection (including Listeria spp., anaerobic bacteria, penicillin-resistant Streptococcus pneumoniae, and herpes simplex virus). Due to impaired coagulation with increased risk of spinal bleeding, a lumbar puncture was initially declined. A cerebral CT scan showed a progression of the subdural lesion to the right frontal lobe, suggestive of an active subdural process, such as empyema (Fig. 1a and 1c). Two days after reconstitution of coagulation, the right frontal part of the lesion was evacuated through a burr hole for microbiological workup. An intraventricular drain (IVD) was inserted on the contralateral side. The intraoperative macroscopic findings supported the radiological diagnosis of subdural empy...

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“…In many parts of the world, clostridial diseases are a constant threat to successful livestock production. The genus Clostridia is divided to histotoxic and neurotoxic Clostridia (2). The members of histotoxic Clostridia are invasive and cause extensive destruction of muscle and connective tissue and are characterized by the formation of gas, including Clostridium chavoei, C. colinum, C. hemolyticum, C. novyi, C. perfringens, C. septicum and C. sordellii.…”

Section: Contextmentioning

confidence: 99%

Isolation, Specification, Molecular Biology Assessment and Vaccine Development of Clostridium in Iran: A Review

Langroudi

2015

Int J Enteric Pathog

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Context: The genus Clostridium, which consists of spore-forming anaerobes, can cause different diseases in domestic animals and human and some of them are serious and fatal. According to the increasing economic value of the meat and milk-producing animals, the importance of a certain number of such diseases in Iran is unquestionable. Evidence Acquisition: In Iran, and probably in other Near East countries, much attention was formerly paid to control more serious contagious diseases, such as rinderpest, anthrax, etc. resulting in the negligence of diseases such as enterotoxaemia. The epizootiological position has now changed whereby some of the contagious diseases are eradicated or are being methodically controlled. Now it is time to care about the other problems such as clostridial diseases, which threaten the health of the sheep and cattle. It is impossible to eradicate these infectious microorganisms, since they are normally found in the soil and the intestinal contents of apparently healthy animals. Therefore, it is necessary to resort to vaccination which in some cases has given encouraging results. To avoid the losses from such infections it is necessary to have the best possible vaccination information, methodically and regularity of the susceptible animals. Conclusions: This review refers to the veterinary aspects of the anaerobic clostridial diseases and vaccine development concerning the works carried out in Iran and especially at the Razi Serum and Vaccine Research Institute in the last eight decades.

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Neuromuscular and Central Nervous System Manifestations of Clostridium perfringens Infections

Cited by 35 publications

References 98 publications

The CpAL Quorum Sensing System Regulates Production of Hemolysins CPA and PFO To Build Clostridium perfringens Biofilms

The CpAL Quorum Sensing System Regulates Production of Hemolysins CPA and PFO To Build Clostridium perfringens Biofilms

Meningoencephalitis with Subdural Empyema Caused by Toxigenic Clostridium perfringens Type A

Isolation, Specification, Molecular Biology Assessment and Vaccine Development of Clostridium in Iran: A Review

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