1/197. Chronic clostridium septicum infection of a tibial fracture: a case report.An open transverse fracture of the mid-shaft of the tibia of a professional footballer became infected by clostridium septicum and, after early compression plating, required surgical intervention on three further occasions and extensive antibiotic treatment before healing occurred. Clostridial infection is a recognized complication of open fractures contaminated with soil, and the necrotizing toxins produced by the C. septicum were probably responsible for the persistence of this infection. Infection occurred in less than 1 per cent of our series of 215 operations of compression plating of fresh fractures of the tibial shaft. Infection by clostridium species is a serious complication of open fractures. This patient did not show the spreading inflammation and necrosis, or the marked systemic upset, characteristic of acute clostridial infection, but persistent local infection necessitated prolonged surgical and antibiotic treatment.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/197. clostridium perfringens: a rare cause of postoperative spinal surgery meningitis.BACKGROUND: clostridium perfringens is a rare cause of central nervous system infections, particularly meningitis. The case of a 76-year-old man who developed fatal C. perfringens meningitis after routine decompressive laminectomy for spinal stenosis is described. CASE REPORT: Twelve days after surgery the patient presented with pain and serosangiunous drainage from the surgical incision site. A swab of the drainage revealed Gram-positive bacilli; MRI of the lumbosacral spine showed the appearance of air around the laminectomy site. The patient died within 6 hours of presentation. autopsy revealed acute cranial and spinal meningitis and choroid plexitis with organisms consistent with C. perfringens. CONCLUSION: No significant enteral pathology or source of endogenous infection was determined, suggesting postoperative wound contamination and meningeal seeding with this ubiquitous organism. Clostridial infection, although rare, should be considered in any patient with meningitis with a history of surgical intervention. survival with minimal neurological deficits was achieved in half of the previously reported cases.- - - - - - - - - - ranking = 0.375keywords = infection (Clic here for more details about this article) |
3/197. Fatal clostridium sordellii ischio-rectal abscess with septicaemia complicating ultrasound-guided transrectal prostate biopsy.clostridium sordellii is a Gram-positive spore-forming anaerobic bacillus rarely encountered in human infection. A case of C. sordellii ischio-rectal abscess with rapidly fatal septicaemia is described which complicated ultrasound-guided transrectal biopsy of the prostate, despite ciprofloxacin prophylaxis. Neither C. sordellii ischio-rectal abscess nor ischio-rectal abscess complicating transrectal biopsy have been reported previously. Judging from our experience and the reviewed literature, the addition of prophylactic anti-anaerobe drugs should be strongly considered until an optimal prophylactic regimen will be defined by randomized controlled trials.- - - - - - - - - - ranking = 0.125keywords = infection (Clic here for more details about this article) |
4/197. clostridium difficile infection of a prosthetic joint presenting 12 months after antibiotic-associated diarrhoea.clostridium difficile is a common cause of antibiotic-associated diarrhoea, but it rarely causes extra-colonic disease. An 83-year-old woman who developed culture-positive C. difficile-associated diarrhoea following pneumonia and a total hip replacement was treated successfully with oral metronidazole therapy. She was readmitted 12 months later for revision of the hip prosthesis because of increasing pain. At surgery an abscess associated with the prosthesis was discovered. culture of the pus grew C. difficile. When the surgical isolate and the cryopreserved faecal isolates were compared using Pulsed Field Gel electrophoresis (PFGE), an identical banding pattern was observed. This case extends the clinical spectrum of C. difficile infection by documenting a prolonged interval between the initial infection, and diagnosis of the prosthetic joint infection. The importance of molecular typing to show strain relatedness is demonstrated.- - - - - - - - - - ranking = 0.875keywords = infection (Clic here for more details about this article) |
5/197. Case report: clostridium septicum infection presenting as liver abscess in a case of choriocarcinoma with liver metastasis.clostridium septicum is an anaerobic, gram-positive bacillus. Infection with this organism has a known association with malignant diseases, especially colon and haematological cancers. clostridium septicum is rarely found to be a pathogen of liver abscess. Herein, we report the case of a female choriocarcinoma patient with liver metastasis in which C. septicum infection presented as a gas-forming liver abscess. This case and previous reports indicate that once C. septicum is identified as a pathogen in liver abscess, metastatic liver tumours should be highly suspected.- - - - - - - - - - ranking = 0.625keywords = infection (Clic here for more details about this article) |
6/197. The role of clostridium septicum in paraneoplastic sepsis.CONTEXT: clostridium septicum infections are rare but often associated with serious if not fatal outcomes. clostridium septicum infection does not appear to be associated with a single specific defect in cellular or humoral immunity. It has been associated with multiple medical problems, including but not limited to leukemia, malignancy of the bowel, other solid tumors, cyclic neutropenia with enterocolitis, diabetes mellitus, and severe arteriosclerosis. Most cases of C septicum are associated with malignancy, and mortality approaches 100% if care is not rendered within 12 to 24 hours. OBJECTIVES: To evaluate outcomes of patients with C septicum bacteremia, whether treated medically or surgically or both, and to note associated conditions. DESIGN: Retrospective evaluation of patients found to have C septicum bacteremia in the past 6 years. SETTING: Two teaching hospitals, Brooke Army Medical Center (250 beds) and Wilford Hall Medical Center (292 beds), were the source of our patients. patients: All patients found to have C septicum bacteremia during hospitalization or postmortem examination were included in the study. There were no exclusion criteria. MAIN OUTCOME MEASURE: mortality associated with C septicum infection. RESULTS: In our case series, mortality was 33%, which is slightly lower than reported in prior studies (43%-70%). CONCLUSION: Presumptive identification based on Gram stain, awareness of C septicum infection as a paraneoplastic syndrome, and prompt, clear communication between laboratory personnel and clinicians are necessary for early diagnosis of C septicum infection. Early institution of antibiotic therapy improves prognosis.- - - - - - - - - - ranking = 0.625keywords = infection (Clic here for more details about this article) |
7/197. CNS infection with clostridium septicum.We present an unusual case of clostridium septicum brain infection in a 72-yr-old woman who had no underlying malignant disease. The infection spread from a localized sit to the CNS causing gas formation. The patient died rapidly.- - - - - - - - - - ranking = 0.75keywords = infection (Clic here for more details about this article) |
8/197. The clinical spectrum of clostridium sordellii bacteraemia: two case reports and a review of the literature.clostridium sordellii is rarely associated with disease in humans. Since its first report in 1922 only a few cases of bacteraemia have been reported. This report describes two cases of C sordellii bacteraemia; the oldest and youngest patients reported to date. The first, is a previously well 81 year old woman presented with perianal infection, which was later complicated by thrombosis of the aorta, and the second is a 12 year old boy with epilepsy who presented with an ear infection. These cases are also highlighted to demonstrate the wide spectrum of presentation of sordellii bacteraemia.- - - - - - - - - - ranking = 0.25keywords = infection (Clic here for more details about this article) |
9/197. Postpartum clostridium sordellii infection associated with fatal toxic shock syndrome.Clostridium bacteria are anaerobic Gram positive spore-form-ing bacilli, known to cause distinct clinical syndromes such as botulism, tetanus, pseudomembranous colitis and myonecrosis. The natural habitats of Clostridium species are soil, water and the gastrointestinal tract of animals and humans. In 5-10% of all women, Clostridium species are also found to be normal inhabitants in the microbial flora of the female genital tract. In case of a non-sexually transmitted genital tract infection, Clostridium species are isolated in 4-20%, and clostridium welchii seems to be the most common isolate. clostridium sordellii is rarely encountered in clinical specimens (1% of Clostridium species), but it has been described as a human pathogen with fatal potential. Two toxins, a lethal and a hemorrhagic (that antigenically and pathophysiologically appear similar to clostridium difficile toxins B and A, respectively) are responsible for this potential. Reviewing the obstetric literature, only six cases of postpartum endometritis caused by C. sordellii, are described - all being fatal. In addition, one lethal case of spontaneous endometritis resulting from C. sordellii is reported. The clinical aspects of these cases include: - sudden onset with influenza-like symptoms in previously healthy women - progressive refractory hypotension - local and spreading tissue edema - absence of fever Laboratory findings include: - marked leukocytosis - elevated hematocrit. This paper reports the seventh fatal postpartum C. sorlellii associated toxic shock syndrome - the first recognized in scandinavia.- - - - - - - - - - ranking = 0.625keywords = infection (Clic here for more details about this article) |
10/197. Clostridium sordelli infection.A case of human Clostridium sordelli soft tissue infection is presented. Analysis of this patient's course led to the use of a mouse experimental model for examination of this organism's potential for toxin production. Data thus obtained correlated with that seen in this instance of human infection, indicates that the lethal effects of this organism may be related to the ability to Clostridium sordelli to produce a widespread "toxin-mediated" edema with subsequent marked "third-space" sequestration of fluid.- - - - - - - - - - ranking = 0.75keywords = infection (Clic here for more details about this article) |
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