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Toxic Shock Syndrome and Other Related Severe Infections
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Table 11.3 illustrates the pertinent laboratory findings that can assist with diagnosis of invasive clostridial infections. The rapid progression of the infection from symptom onset to death also complicates the clinician's ability to administer treatment in an impactful time frame. Resistance studies suggest most C. sordellii strains are susceptible to several antibiotics including β-lactams, vancomycin, tetracycline, imipenem, linezolid, chloramphenicol, metronidazole, clindamycin, and clindamycin adjuvants [31]. Table 11.4 illustrates the recommended antibiotic treatment for invasive infections caused by clostridial species. Recent studies in murine models suggest that clindamycin may have unique efficacy in treating gas gangrene, as it can decrease toxin synthesis and the release of cytokines such as tumor necrosis factor-α (TNF-α) that lead to hypotension and other features of clinical toxic shock [32, 33]. At this time, C. sordellii antitoxins remain unavailable, although their development would likely prove to be a great advancement in the treatment of C. sordellii infection [9]. In addition to the available antibiotic regimens, debridement of necrotic tissue remains a cornerstone of treatment, as it represents the most efficient means of source control [34]. In all autopsy reports of patients with postpartum or postabortion C. sordellii infection, bacteria were found in immunohistochemical staining of uterine samples, suggesting that the prompt removal of this infectious source is key.
Radiation Hormesis in Immunity
Published in T. D. Luckey, Radiation Hormesis, 2020
Various reports indicate that irradiation may be beneficial to malaria patients.461 When laryngeal tuberculosis was treated at 10 d intervals with exposures of the neck to 1 Gy of X-rays, some patients responded favorably.256 Repeated exposures to about 1 Gy were advocated as treatment for clostridia infections.126,438,611 This may be the basis for “mountain therapy” once used for tuberculosis.
Fetal and neonatal medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
4.53. Which of the following statements is/are true of necrotizing enterocolitis (NEC)?Clostridia are the primary pathogenic organisms.Incidence increases with decreasing gestational age.The pathogenesis in full-term infants is different from that in premature infants.The presence of gas in the portal vein is pathognomonic.The infant can present with intestinal obstruction a few weeks after recovering from the illness.
Clostridium Symbiosum Sepsis Diagnosed Using Next-Generation Sequencing in a 2 Year Old Child: A Case Report
Published in Fetal and Pediatric Pathology, 2023
There are approximately 1% of blood culture isolates that are due to Clostridium species as a cause of bacteremia. Infections with other Clostridium species are becoming more common, but Clostridium perfringens is still the most prevalent. Intestinal mucosa may become permeable to these organisms that then gain access to the bloodstream. It is common for certain underlying diseases to be associated with clostridial bacteremia including neoplasms (particularly colon cancer), immunodeficiency, perforation of the viscus and appendicitis [9]. By searching MEDLINE, we found only three case reports of human bacteremia caused by Clostridium symbiosum in the English-language literature. The first human infection caused by Clostridium symbiosum was reported in a 70-year-old man with metastatic colon cancer who was cachectic and severely immunocompromised [4]. A second case has been reported by Decousser et al., which involved a 54-year-old man without a history of malignancy or hepatobiliary tract disease [5]. According to Toprak et al., the third patient with metastatic ovarian cancer underwent debulking surgery as well as partial sigmoid removal [6]. This is the fourth report that Clostridium symbiosum causes illness, and the first of its kind to indicate that the anaerobic bacteria causes sepsis in children. According to previous studies, the patients had underlying bowel disease that increased their risk for bacteremia.
Short-term supplementation with ω-3 polyunsaturated fatty acids modulates primarily mucolytic species from the gut luminal mucin niche in a human fermentation system
Published in Gut Microbes, 2022
Charlène Roussel, Sara Anunciação Braga Guebara, Pier-Luc Plante, Yves Desjardins, Vincenzo Di Marzo, Cristoforo Silvestri
In line with the pronounced decline of mucolytic bacteria upon ω-3 PUFA supplementation that predominantly belonged to the Clostridia class (Firmicutes phylum, Ruminococcus spp., Oscillibacter spp., Dorea spp.) (Figure 3b-c, Figure 4), concurrent significant gradual decreases were observed specifically in other non-mucolytic genus members of this class in the gut lumen (Figure 4). Agathobacter, Coprococcus, Monoglobus, Flavonifractor, Hungatella and Intestinimonas were significantly depleted in all luminal gut habitats over the course of the ω-3 PUFA supplementation. Other Clostridia displayed habitat preference for distal segments during the vehicle supplementation, such as Candidatus_Soleaferrea, Christensenellaceae_R-7_group, Eisenbergiella, Lactonifactor and Negativibacillus and were significantly decreased in response to the ω-3 PUFAs (Figure 4). Strikingly, this time-dependent decrease of Clostridia was stable over the course of 1-week supplementation. Independent of the Clostridia class, the Collinsella genus of class Coriobacteriia as well as the Enterococcus and Erysipelatoclostrium genera of class Bacilli were also decreased. On the contrary, genera belonging from Gamma-Proteobacteria (Escherichia-Shigella, Klebsiella, Sutterella) and Negativicutes (Megasphaera, Dialister, Veillonella) classes were stimulated under ω-3 PUFA supplementation (Figure 5).
Clostridium Septicum Endogenous Endophthalmitis as the Initial Manifestation of Colorectal Carcinoma: Clinical Case Report and Literature Review
Published in Ocular Immunology and Inflammation, 2022
José L. Sanchez-Vicente, Miguel Contreras-Díaz, Fernando López-Herrero, Ana Martínez-Borrego, Antonio Galván-Ledesma, Oscar Lozano-Bernal, Mercedes García-Vazquez, Juan De Las Morenas-Iglesias, Manuel Caro-Magdaleno
Clostridial infections have been associated with malignancy in numerous reports. Kornbluth et al.9 conducted a review of reported cases of atraumatic C. septicum infection and identified a total of 162 patients; of these, 40% presented with a hematologic malignancy and 34% had colorectal carcinoma. On further investigation, 37% of patients with clostridial infection were found to harbor an occult malignancy; the infection was, therefore, the first sign of the malignancy, as in the case we report here. Of the clostridial species, C. septicum is the most frequently associated with malignancy. The relationship between C. septicum infection and malignancy was clearly defined by Koransky et al.,10 in a report regarding a series of 59 patients. The portal of entry of C. septicum into the bloodstream appeared to be focal necrotic areas in the wall of the colon, where the acidic and anaerobic environment created by the neoplasm favored the germination of clostridial spores. When considering clostridial sepsis, it must be remembered that the condition is often fatal, despite treatment with appropriate antibiotics.