Bacteriemia por Clostridium sordellii en paciente con neoplasia gastrointestinal. Reporte de caso y revisión de literatura / Clostridium sordellii bacteremia in a patient with gastrointestinal neoplasia. Case report and review of the literatura

La bacteriemia por Clostridium sordellii es infrecuente y usualmente se origina a partir de infecciones de etiología generalmente ginecológica y puerperal, con una mortalidad de aproximadamente el 70%. Existen pocas herramientas para el diagnóstico rápido y oportuno, siendo así la experiencia de tratamiento para este germen muy limitada en otros escenarios, lo que probablemente sea la causa de su alta mortalidad. Presentamos una paciente con antecedente de masa abdominal expansiva de larga data, con diagnóstico por histopatología e inmunohistoquimica compatibles con tumor del estroma gastrointestinal (GIST por sus siglas en inglés) y estudios de extensión que confirman compromiso metastásico hepático, en quien se documenta bacteriemia por Clostridium sordellii.

Clostridium sordellii bacteriemia is infrequent and usually comes from infections of gynecological and puerperal etiology, with mortality near 70%. There are few tools for rapid and timely diagnosis. Thus, treatment experience for this pathogen is very limited in other scenarios, which is probably the cause of high mortality rates. We describe a patient with a history of expansive abdominal mass, diagnosed with metastasic Gastrointestinal Stromal Tumor (GIST), with Clostridium sordellii bacteremia.

A Case of Clostridium sordellii Bacteremia in a Patient with Osteosarcoma / 감염과화학요법

Clostridium sordellii is a gram-positive spore forming anaerobic bacillus, rarely encountered in human infection. It produces several exotoxins which contribute to myonecrosis, pulmonary infection, obstetric infection and bacteremia. C. sordellii bacteremia is very rare and has been reported in few patients with malignancy or immunosuppression. To date, there has been no report in Korea. Mortality is high when deep site infection exists regardless of underlying pathology and immune status. In contrast, superficial skin and subcutaneous tissue infection has a favorable prognosis. We present a case of C. sordellii bacteremia in a patient with osteosarcoma. The patient was admitted for the treatment of the infection at the ulcerative osteosarcoma lesions of the leg, and C. sordellii bacteremia was demonstrated. He was successfully treated with intravenous ampicillin/sulbactam for two weeks.

A Case of Clostridium sordellii Bacteremia in a Patient with Osteosarcoma / 감염과화학요법

Clostridium sordellii is a gram-positive spore forming anaerobic bacillus, rarely encountered in human infection. It produces several exotoxins which contribute to myonecrosis, pulmonary infection, obstetric infection and bacteremia. C. sordellii bacteremia is very rare and has been reported in few patients with malignancy or immunosuppression. To date, there has been no report in Korea. Mortality is high when deep site infection exists regardless of underlying pathology and immune status. In contrast, superficial skin and subcutaneous tissue infection has a favorable prognosis. We present a case of C. sordellii bacteremia in a patient with osteosarcoma. The patient was admitted for the treatment of the infection at the ulcerative osteosarcoma lesions of the leg, and C. sordellii bacteremia was demonstrated. He was successfully treated with intravenous ampicillin/sulbactam for two weeks.

Clostridium sordellii as a cause of enteritis in lambs

During 2004-2005, out of 25 lambs up to 10 weeks old which died suddenly, 13 Clostridium sordellii were isolated. The post- mortem findings varied. Losses have been sporadic in some farms in Kafer el-Sheikh governorate and recorded in all age of lambs. Also, 61 fecal samples of diarrheic lambs at three different age groups, were examined bacteriological ly for the presence ofclostridia with special emphasis on C. sordellii, the isolation rate of C. sordellii was higher in all age groups [24.6, 8.3, and 5%] than other Clostridium species. C.perfringens, C. sporogenes, and C. bifermentans were isolated and identified in a different percentage. In vitro, the sensitivity of C. sordellii isolates to different chemotherapeutic agents was determined .Results of this study indicates that Clostridium sordellii should be considered when investigating the cause of sudden death in lambs