Cases reported "Clostridium Infections"

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1/12. Characteristics of a strain of Clostridium carnis causing septicaemia in a young infant.

    Clostridium carnis is a species which is only rarely isolated from man or animals and is occasionally found in the soil. This paper is an account of a single isolate found in blood cultures obtained from an 8-week-old boy who was suffering from gastroenteritis.
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2/12. 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.
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3/12. Clostridium fallax associated with sudden death in a 16-year-old boy.

    Clostridial myonecrosis or gas gangrene occurs most frequently in contaminated wounds following trauma or surgery. It is caused by a wide variety of Clostridium species, the most common being clostridium perfringens. Spontaneous, non-traumatic clostridial myonecrosis is uncommon and is usually associated with gastrointestinal and haematological malignancy, diabetes mellitus and peripheral vascular disease. The case of a previously healthy 16-year-old boy with acute onset of gastrointestinal symptoms, who died of bacterial sepsis without apparent preceding trauma, is presented here. Clostridium fallax was identified as the most probable causative agent. As far as is known, this is the first report of fatal sepsis in humans due to C. fallax, which has been described only rarely as a cause of gas oedema in animals.
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4/12. clostridium perfringens corneal ulcer.

    A corneal ulcer caused by clostridium perfringens developed in a 76-year-old woman with sjogren's syndrome. Experimental C perfringens keratitis was induced in rabbits by the intrastromal injection of 10(7) organisms. In both our patient and the experimental animals, a bullous lesion overlay the affected area of the cornea. This may be a specific lesion in clostridial infections of the cornea. clostridium perfringens should be regarded as an opportunistic corneal pathogen, and anaerobic cultures should be performed in all cases of suspected bacterial corneal ulcer.
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5/12. clostridium septicum as a cause of pericarditis and mycotic aneurysm.

    clostridium septicum is a bacterial species associated with gas gangrene in both humans and animals. Although not usually a pathogen in humans, it has been implicated in some cases of abscesses and bacteremia. We now report the first case of pericarditis with mycotic aneurysm due to C. septicum.
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6/12. Maternal deaths associated with clostridium sordellii infection.

    clostridium sordellii is a common soil and enteric bacterium that is infrequently recovered from the vagina. We describe three women in which C. sordellii caused puerperal infection and a distinctive and lethal toxic shock-like syndrome. patients were less than 1 week post partum and each had a single, limited focus of infection including infection associated with a retained vaginal sponge, a cesarean section operative site, and endometritis. Each patient had a distinctive course characterized by sudden onset of clinical shock marked by severe and unrelenting hypotension associated with marked, generalized tissue edema and "third spacing" with increased hematocrit, presence of marked leukemoid reaction with total neutrophil counts of 84,000/mm3, 66,000/mm3, and 93,600/mm3, absence of rash or fever, limited or no myonecrosis, and a rapid and uniformly lethal course. hypoalbuminemia was also noted. Similar findings were noted in prior isolated reports of C. sordellii-mediated postpartum or surgical infection. Treatment of animals with C. sordellii or closely related C. difficile toxins produces similar findings. We suggest that localized infection with toxin-producing strains of C. sordellii can produce a rapidly lethal toxic shock-like syndrome. Further study and earlier recognition of this syndrome may be life-saving in other patients.
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7/12. Implication of plasma free hemoglobin in massive clostridial hemolysis.

    Prolonged tissue oxygenation and maintenance of intravascular oncotic pressure are severely impaired with the absence of an effective RBC mass. We recently encountered a patient with a nondetectable hematocrit value (0%) attributed to clostridium perfringens hemolysis. The patient maintained normal BP, tissue oxygenation, and mentation and survived longer than four hours, despite ineffective transfusion therapy. plasma free hemoglobin was responsible for the preservation of tissue oxygenation, intravascular oncotic pressure, and pH. Existing studies in animals support stroma-free hemoglobin as an effective blood product in humans.
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8/12. Nosocomial spread of clostridium difficile.

    Environmental transmission of clostridium difficile, the causative agent of antibiotic-associated pseudomembranous colitis (PMC), has been supported by animal studies and implicated in spread of C. difficile among leukemic children receiving non-absorbable antibiotics. We report antibiotic-associated C. difficile-related colitis in two adults who shared a commode chair during hospitalization.
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9/12. Antibiotic-associated colitis due to clostridium difficile in a Kodiak bear.

    clostridium difficile and its toxins usually are present in feces of laboratory animals and persons with antibiotic-associated colitis. We report antibiotic-associated colitis in a captive Kodiak bear (Alaskan brown bear, Ursus arctos) in which C difficile and its cytotoxin were found in feces. This indicates that the colitis associated with C difficile and its toxins can occur in nonlaboratory large animals and that this organism may be the causative agent in certain cases of idiopathic colitis in animals. This case also indicates that nonlaboratory animals may be a source of the organism.
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10/12. clostridium difficile colitis associated with cancer chemotherapy.

    Administration of cancer chemotherapeutic agents to humans and animals is frequently complicated by diarrhea and enterocolitis. clostridium difficile and its toxin were found in the stools of two patients with colitis after chemotherapy for malignant neoplasms. diarrhea in both patients resolved with oral vancomycin hydrochloride therapy. clostridium difficile was also isolated from several fomites within the room of one of these patients and also from the hands of his nurses. Based on these two recent experiences, we believe patients with cancer and diarrhea or signs suggestive of colitis should be studied for toxigenic C difficile and appropriate isolation techniques employed.
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