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BMJ Case Rep ; 20162016 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-27489063

RESUMO

Clostridium sordellii is a spore-forming anaerobic Gram-positive rod that has rarely been reported to cause disease in humans. Resultant mortality from infection is estimated at nearly 70% and is most often correlated with gynaecological procedures, intravenous drug abuse or trauma. C. sordellii infection often presents similarly to toxic shock syndrome (TSS); notable features of infection include refractory hypotension, haemoconcentration and marked leucocytosis. Although clinically similar to TSS, a notable difference is C. sordellii infections rarely involve fever. The organism's major toxins include haemorrhagic (TcsH) and lethal factor (TcsL), which function to disrupt cytoskeletal integrity. Current literature suggests treating C. sordelli infection with a broad-spectrum penicillin, metronidazole and clindamycin. We present a case of C. sordellii bacteraemia and septic shock in an immunocompromised patient who was recently diagnosed with pleomorphic gluteal sarcoma. Despite presenting in critical condition, the patient improved after aggressive hemodynamic resuscitation, source control and intravenous antibiotic therapy.


Assuntos
Bacteriemia/diagnóstico , Infecções por Clostridium/diagnóstico , Clostridium sordellii , Hospedeiro Imunocomprometido , Lipossarcoma/microbiologia , Idoso , Antibacterianos/administração & dosagem , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/microbiologia , Diagnóstico Diferencial , Feminino , Humanos , Choque Séptico
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