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At least 577 records · Page 32Linked to original sources
PubMed1984

Necrotizing enterocolitis and hemolysis associated with Clostridium perfringens.

Two newborns had necrotizing enterocolitis (NEC) and severe hemolytic anemia. Clostridium perfringens was identified in the peritoneal fluid of both infants, supporting the previous association of C perfringens with hemolysis reported in adult patients. Infants with NEC and hemolytic anemia should be aggressively treated with surgical debridement and high-dose parenteral penicillin G potassium. Similarly, Gram's stain of peritoneal fluid and resected bowel at laparotomy for NEC may be useful for early identification of the primary organism.

Anemia, Hemolytic↗
PubMed1994

Enteritis necroticans with midgut necrosis caused by Clostridium perfringens.

Enteritis necroticans is a necrotizing process manifesting as segmental gangrene of the bowel, triggered by Clostridium perfringens toxins under specific dietary conditions. It is a rare disease in developed countries and is probably underdiagnosed. A case of enteritis necroticans presenting with midgut necrosis with sepsis and hemolysis is reported herein. Bacteriologic culture of blood and peritoneal content revealed C perfringens. Dietary history, including the ingestion of meat together with sweet potatoes, should increase clinical suspicion of enteritis necroticans. Early recognition and timely surgical intervention are required for successful treatment. Clinicians are encouraged to be aware of this clinically fulminant yet rarely recognized surgical entity.

Clostridium Infections↗
PubMed1992

Emphysematous cystitis due to Clostridium perfringens and Candida albicans in two patients with hematologic malignant conditions.

BACKGROUND: Fever, abdominal pain, and hematuria developed in two patients with hematologic malignant conditions (multiple myeloma and agnogenic myeloid metaplasia). Each patient was found to have emphysematous cystitis (EC), secondary to Clostridium perfringens and Candida albicans, respectively. Both patients had debilitated general medical conditions, compromised immune function, prior treatment with broad-spectrum antibiotics and corticosteroids, bladder outlet obstruction, and indwelling Foley catheters as predisposing factors to EC. Neither was diabetic. METHODS: These cases provide an opportunity to review the related medical literature on the pathophysiology and management of this uncommon entity. RESULTS: Treatment consists of control of underlying diabetes (if present), administration of appropriate antibiotics, establishment of urinary drainage, provision of supportive general medical care, exclusion of the presence of a bladder fistula, and surgical debridement only when unavoidable. CONCLUSIONS: EC should be part of the differential diagnosis in patients with cancer who have fever, abdominal pain, and hematuria.

Aged↗
PubMed1985

Clostridial toxins active locally in the gastrointestinal tract.

Clostridium difficile and Clostridium spiroforme have only in recent years been recognized as intestinal pathogens. They both produce toxins that are also produced by other clostridia. C. difficile toxins A and B are produced by C. sordellii and a few strains of C. perfringens whereas C. spiroforme produces the same toxins as C. perfringens Type E (iota toxin). Iota toxin activity may be the product of two proteins. Toxigenic strains of C. spiroforme and Type E produce two antigens which possess much more biological activity when administered together than when given alone. C. difficile was thought for some time to produce only a single toxin, but then the enterotoxic activity was shown to be due to a separate toxin (toxin A). This toxin increases the oral toxicity of toxin B (the main cytotoxin) and may increase the permeability of the colon. Toxin A binds to a specific receptor in hamster brush border membranes and in the membranes of rabbit erythrocytes. This receptor appears to be a glycoprotein. The receptor can be extracted from the membrane with Triton and binds to immobilized toxin A. The receptor can be extracted and used to coat plastic plates as a first phase in an ELISA assay. Another assay has been developed in which the toxin A binds to the red cells and then the erythrocytes are agglutinated with antitoxin. An even more sensitive assay consists of using rabbit erythrocyte ghosts to bind the toxin and then precipitating the ghosts with antibody to toxin A attached to latex beads. Monoclonal antibodies to toxin A also have been developed and are used in these and other assays.

Animals↗
PubMed1988

Clostridial septic arthritis: case report and review of the literature.

We describe a patient who had septic arthritis caused by Clostridium perfringens. Clostridial organisms are very uncommon causes of septic arthritis. Only 13 cases have been reported previously. The diagnosis should be suspected in patients with a history of penetrating joint trauma and in immunocompromised patients. Successful treatment has usually consisted of surgical synovectomy in combination with high-dose intravenous penicillin therapy. Multiple aspirations of affected joints as a definitive treatment should be used with caution and only in patients who are not candidates for surgery.

Adult↗
PubMed1981

The surgical treatment of enteritis necroticans.

The optimum timing of surgery in acute cases of enteritis necroticans with bowel obstruction has not been established. Two similar groups of patients with this condition were sequentially compared to determine if early surgical intervention reduces mortality. In the first group 42 per cent of the 79 patients received medical treatment only and 58 per cent had an operation at a median time of 4 days following the onset of obstruction. In the second group 96 per cent of the 50 patients received surgery at a median time of 2 days following the onset of obstruction and 4 per cent received medical treatment only. The mortality in the second group (21 per cent) was half that of the first group (43 per cent). Surgery after a short period of resuscitation is advocated for all cases of enteritis necroticans with bowel obstruction.

Acute Disease↗
PubMed1978

Clostridial sepsis after abortion with PGF2alpha and intracervical laminaria tents--a case report.

A case of clostridial endomyometritis and sepsis necessitating total abdominal hysterectomy which occurred 12 hours following abortion induced with intraamniotic administration of prostaglandin F2 alpha and laminaria tent insertion is discussed. Cultures from cervical, blood, and surgical specimens all yielded Clostridium perfringens. Intrauterine contamination with this microorganism most likely followed the insertion of laminaria tents through the cervical os, which was colonized with C. perfringens. Since C. perfringens may be present in the microflora of the lower female genital tract, great care must be taken to cleanse this area prior to intracervical laminaria tent insertion.

Abortion, Induced↗
PubMed1997

Human disease associated with Clostridium perfringens enterotoxin.

Clostridium perfringens continues to be a common cause of food-borne disease. Characteristics of this organism that contribute to its ability to cause food-borne illness include the formation of heat-resistant spores that survive normal cooking/heating temperatures, a rapid growth rate in warm food, and the production of enterotoxin (CPE) in the human gut. Time and temperature abuse associated with food preparation contributes to the majority of outbreaks of C. perfringens food-borne disease. CPE-induced diarrhea has been reported in the absence of a defined food vehicle. These cases have been typically associated with the elderly and following a course of antibiotic therapy. The incidence of CPE-induced diarrhea may be expected to increase with the growing population of immunocompromised (disease-, treatment-, or age-induced) individuals. Clostridium perfringens has been implicated as a possible contributor to the development of SIDS in susceptible individuals. Specifically, it has been hypothesized that CPE acts as a triggering agent, initiating the events associated with the development of SIDS. Continued refinement of both immunoassays and molecular methods for toxin and gene detection, respectively, will facilitate their eventual availability as commercial kits, providing rapid and simplified methods for the detection of C. perfringens isolates that produce or have the capacity to produce CPE as well as other toxins associated with this organism.

Clostridium Infections↗