Non-lethalClostridium sordelliibacteraemia in an immunocompromised patient with pleomorphic sarcoma

Abstract

Clostridium sordellii is a spore-forming anaerobic Gram-positive rod that has rarely been reported to cause disease in humans. Resultant mortality from infection is estimated at nearly 70% and is most often correlated with gynaecological procedures, intravenous drug abuse or trauma. C. sordellii infection often presents similarly to toxic shock syndrome (TSS); notable features of infection include refractory hypotension, haemoconcentration and marked leucocytosis. Although clinically similar to TSS, a notable difference is C. sordellii infections rarely involve fever. The organism's major toxins include haemorrhagic (TcsH) and lethal factor (TcsL), which function to disrupt cytoskeletal integrity. Current literature suggests treating C. sordelli infection with a broad-spectrum penicillin, metronidazole and clindamycin. We present a case of C. sordellii bacteraemia and septic shock in an immunocompromised patient who was recently diagnosed with pleomorphic gluteal sarcoma. Despite presenting in critical condition, the patient improved after aggressive hemodynamic resuscitation, source control and intravenous antibiotic therapy.

Infective Endocarditis Caused by C. sordellii: The First Case Report from India

“…Since C. sordellii's first isolation in the year 1922, it has been commonly linked with lethal posttraumatic skin and soft tissue infections, penetrating injury, medical abortions, pericarditis along with some reported cases of bacteremia (►Table 1). [8][9][10][11][12][13][14] The pathogenicity of C. sordellii by productions of exotoxins are associated with toxic shock syndrome. 15 Off these exotoxins, lethal toxin and hemorrhagic toxin are two major virulence factors, which showed antigenic as well as pathophysiological resemblance to C. difficile toxins B and A, respectively.…”