Rapidly Progressive Necrotizing Fasciitis and Gangrene Due to Clostridium difficile: Case Report

Bhargava, Abha; Sen, Purnendu; Swaminathan, Anangur P.; Ogbolu, Cora; Chechko, Susan; Stone, Frederick H.

doi:10.1086/313825

Cited by 17 publications

(10 citation statements)

References 4 publications

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“…The patient's condition improved with extensive wound debridement and the administration of multiple antibiotics, including intravenous metronidazole. 11 In the present patient, the administration of metronidazole after the identifi cation of a causative agent was more effective than the irrigation of the surgical wound and the administration of other antibiotics. We consider that metronidazole may be also a key drug for the treatment of soft-tissue infections caused by C. diffi cile.…”

Section: Discussionmentioning

confidence: 59%

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Kikkawa

Miyamoto

Takiguchi

et al. 2008

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 59%

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Kikkawa

Miyamoto

Takiguchi

et al. 2008

Journal of Infection and Chemotherapy

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“…2 In contrast, extracolonic infections have been reported rarely. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Extracolonic manifestations of C. difficile include bacteremia, osteomyelitis, visceral abscess, empyema, reactive arthritis, and small bowel disease with the formation of pseudomembranes on the ileal mucosa. Most cases of extracolonic C. difficile have been preceded by gastrointestinal disease, either C. difficile colitis or surgical and anatomical disruption of the colon.…”

Section: Introductionmentioning

confidence: 99%

Bacteremia due to Clostridium difficile—review of the literature

Libby

Bearman

2009

International Journal of Infectious Diseases

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Extracolonic Clostridium difficile infections have been infrequently reported. Extracolonic manifestations of C. difficile include bacteremia, intra-abdominal abscess, osteomyelitis, visceral abscess, empyema, reactive arthritis, and small bowel disease with formation of pseudomembranes on ileal mucosa. Most cases of extracolonic C. difficile have been preceded by gastrointestinal disease, either C. difficile colitis or surgical and anatomical disruption of the colon. Bacteremia due to C. difficile has previously been described in 14 patients with underlying gastrointestinal processes. We report a unique case of monomicrobial C. difficile bacteremia in a young woman with an underlying hematologic malignancy. The patient lacked gastrointestinal symptoms or radiologic findings suggestive of colitis or ongoing gastrointestinal pathology.

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“…We did not find any case of severe sepsis secondary to a fulminant pseudomembranous colitis as described elsewhere [21]. Fewer than a dozen cases of clearly established skin and soft tissue infection and osteomyelitis have been reported [22–29]. Again, the spreading of C. difficile through contaminated wounds after trauma or surgical injury may be potentially misleading.…”

Section: Discussionmentioning

confidence: 58%

Extra-intestinal infections caused by Clostridium difficile

GarcÃa-Lechuz

Hernangómez

Juan

et al. 2001

Clinical Microbiology and Infection

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The objective of this paper was to investigate the incidence of extra-intestinal infections caused by Clostridium difficile. During a 10-year period, the microbiology laboratory of our institution isolated 2034 isolates of C. difficile. Of the 2034 isolates, 21 (1.08%) were obtained from extra-intestinal sources. This represents an incidence of extra-intestinal isolation of four cases per 100 000 admissions. We were able to review the records of 17 patients for our study. The isolates in 12 patients were obtained from structures or fluids anatomically close to the colon and included the following infections: peritonitis in five cases (three primary and two secondary), intra-abdominal abscesses in three patients and abdominal wound infections in four cases. The infections in the other five patients were not in the anatomic vicinity of the colon. They included one case with a brain abscess, two episodes of bacteremia and two cases of foot infections (one chronic osteomyelitis). In all but one case, C. difficile isolation was obtained as part of a polymicrobial flora. The isolates were frequently non-toxigenic and the extra-intestinal infections occurred without concomitant diarrhea or prior anti-microbial therapy. Out of the 17 patients, eight died and nine survived. Death could not be directly attributed to C. difficile in any of the cases. The isolation of C. difficile outside the intestinal tract is very uncommon. Its clinical significance should be interpreted with caution.

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Rapidly Progressive Necrotizing Fasciitis and Gangrene Due to Clostridium difficile: Case Report

Abstract: A case of rapidly progressive necrotizing fascitis and gas gangrene due to Clostridium difficile that responded very well to surgical intervention is described.

Cited by 17 publications

References 4 publications

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Bacteremia due to Clostridium difficile—review of the literature

Extra-intestinal infections caused by Clostridium difficile

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