Presentation
The lack of TscL likely explains the positive outcome and absence of TSS-like presentation in these cases. [ncbi.nlm.nih.gov]
C. sordellii, a pathogen that is infrequently found in humans, has a broad spectrum of clinical presentations. [academic.oup.com]
Mortality correlated with both shock and leukemoid reaction at presentation. We present a case of C. sordellii sepsis in an asplenic patient with sickle beta thalassemia and inflammatory bowel disease, and we review the literature. [pubmed.ncbi.nlm.nih.gov]
The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU) for initiation of peritoneal dialysis (PD). [hindawi.com]
Entire Body System
- Fever
In addition, a fatal case of C. sordellii toxic shock syndrome after medical abortion with mifepristone and misoprostol was reported in 2001, in Canada.2 All three cases of C. sordellii infection were notable for lack of fever, and all had refractory [jamanetwork.com]
Classic symptoms of C. sordellii infection include leukemoid reaction, hypotension, haemoconcentration, tachycardia and the absence of fever. [ncbi.nlm.nih.gov]
Symptoms of C. sordellii infection Symptoms of a C. sordellii infection include nausea, vomiting, diarrhea, and sometimes abdominal pain without fever. [cdc.gov]
The following day he had decreased urine output, elevated blood pressure, lower extremity and eyelid edema, and fever of 38.5°C. [hindawi.com]
- Swelling
Earlier diagnosis among injection drug users is more common than in other cases of infection, however, because of the apparent swelling, pain and redness at the site of injection [1]. [microbewiki.kenyon.edu]
Autopsy Findings At autopsy, examiners observed extensive swelling of the soft tissues, fluid accumulations in the body cavities, and terminal ischemic changes in the bowel mucosa and liver, all of which were consistent with cardiovascular collapse secondary [ncbi.nlm.nih.gov]
- Malaise
Gynecological patients usually seek treatment with nonspecific symptoms, such as malaise, low or absent fever, nausea, and pain at the infection site. [ncbi.nlm.nih.gov]
- Hypoxemia
Refractory bradycardia, hypotension, and hypoxemia developed, and the patient died approximately 10 hours after admission. [nejm.org]
Respiratoric
- Pneumonia
Is capable of causing pneumonia, endocarditis, arthritis, peritonitis and myonecrosis, bacteremia and sepsis occur rarely. Most cases of sepsis from C. sordellii occur in patients with underlying conditions. [microbe-canvas.com]
Clostridium sordellii (Hall and Scott, 1927) Prévot, 1938 Bacillus sordellii Hall and Scott, 1927 (not validly published) Paeniclostridium sordellii is a rare anaerobic, gram-positive, spore-forming rod with peritrichous flagella that is capable of causing pneumonia [en.wikipedia.org]
Transmission of C. sordellii infection What CDC is doing Additional Information General Information about C. sordellii Clostridium sordellii [klaw–strĭ–dee–um sore–dell–ee–i] (also called C. sordellii) is a rare bacterium that causes pneumonia, endocarditis [cdc.gov]
Am J Obstet Gynecol. 1979; 134: 173-179 Scopus (31) PubMed Abstract Full Text PDF Google Scholar File Jr, TM Fass RJ Perkins RL Pneumonia and empyema caused by Clostridium sordellii. [journalofinfection.com]
Gastrointestinal
- Nausea
Symptoms of C. sordellii infection Symptoms of a C. sordellii infection include nausea, vomiting, diarrhea, and sometimes abdominal pain without fever. [cdc.gov]
Gynecological patients usually seek treatment with nonspecific symptoms, such as malaise, low or absent fever, nausea, and pain at the infection site. [ncbi.nlm.nih.gov]
- Abdominal Pain
Most of their signs and symptoms were typical of sepsis and TSS: tachycardia, hypotension, leukocytosis, hemoconcentration, weakness, vomiting, abdominal pain, and diarrhea. [nursingcenter.com]
Five days after taking oral mifepristone, the patient presented to an emergency department with abdominal pain. [journals.lww.com]
Symptoms of C. sordellii infection Symptoms of a C. sordellii infection include nausea, vomiting, diarrhea, and sometimes abdominal pain without fever. [cdc.gov]
In August 2001, a 26-year-old, previously healthy woman was hospitalized because of abdominal pain, vomiting, and foul-smelling vaginal discharge. [academic.oup.com]
Five days after receiving mifepristone, she presented to a local emergency department reporting nausea, vomiting, diarrhea, and severe abdominal pain. [nejm.org]
- Abdominal Cramps
Four days after receiving mifepristone, the patient presented to an emergency department with reports of abdominal cramping and dysuria. She had taken acetaminophen with codeine after the abortion. [nejm.org]
The following day, the patient developed vaginal bleeding, abdominal cramping, vomiting, diarrhea, and chills. [journals.lww.com]
- Severe Abdominal Pain
Five days after receiving mifepristone, she presented to a local emergency department reporting nausea, vomiting, diarrhea, and severe abdominal pain. [nejm.org]
- Abdominal Mass
We describe a patient with a history of expansive abdominal mass, diagnosed with metastasic Gastrointestinal Stromal Tumor (GIST), with Clostridium sordellii bacteremia. Keywords : Clostridium sordellii; sepsis; bacteremia; intraabdominal neoplasm. [scielo.org.co]
Cardiovascular
- Hypotension
Treatment is mainly supportive in regard to hypotension and cardiovascular strain. [hindawi.com]
Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. [nejm.org]
In addition, a fatal case of C. sordellii toxic shock syndrome after medical abortion with mifepristone and misoprostol was reported in 2001, in Canada.2 All three cases of C. sordellii infection were notable for lack of fever, and all had refractory hypotension [jamanetwork.com]
Musculoskeletal
- Arthritis
Is capable of causing pneumonia, endocarditis, arthritis, peritonitis and myonecrosis, bacteremia and sepsis occur rarely. Most cases of sepsis from C. sordellii occur in patients with underlying conditions. [microbe-canvas.com]
Scott, 1927) Prévot, 1938 Bacillus sordellii Hall and Scott, 1927 (not validly published) Paeniclostridium sordellii is a rare anaerobic, gram-positive, spore-forming rod with peritrichous flagella that is capable of causing pneumonia, endocarditis, arthritis [en.wikipedia.org]
Transmission of C. sordellii infection What CDC is doing Additional Information General Information about C. sordellii Clostridium sordellii [klaw–strĭ–dee–um sore–dell–ee–i] (also called C. sordellii) is a rare bacterium that causes pneumonia, endocarditis, arthritis [cdc.gov]
Am J Med. 1987; 83 : 605 Scopus (14) PubMed Abstract Full Text PDF Google Scholar Spindler AJ Musa H Clostridium sordellii septic arthritis. [journalofinfection.com]
Urogenital
- Adnexal Mass
Pelvic examination revealed no uterine tenderness or adnexal mass. No laboratory studies or cultures were performed. She received hydromorphone and promethazine and was discharged taking acetaminophen and codeine. [nejm.org]
- Oliguria
Bigby MA Jones FA Postabortal infection with clostridium welchii; report of two cases with special reference to oliguria and to penicillin treatment. J Obstet Gynaecol Br Emp. 1949; 56: 636-647 35. [thelancet.com]
Workup
Colonoscopy
- Colitis
A report of a case of Clostridium sordellii bacteraemia arising from the gastrointestinal tract in a patient with urological malignancy and radiation colitis. [journalofinfection.com]
Infect Immun. 1988; 56: 1215-1221 PubMed Crossref Google Scholar Rifkin GD Fekety FR Silva J Sack RB Antibiotic induced colitis: implication of a toxin neutralized by Clostridium sordellii antitoxin. [ajog.org]
Some species have been isolated from women with bacterial vaginosis.[3] Species[edit] Notable species of this class include: Clostridium perfringens (gangrene, food poisoning) Clostridioides difficile (pseudomembranous colitis) Clostridium tetani (tetanus [en.wikipedia.org]
We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC) database) infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome [hindawi.com]
Laboratory
- Leukocytosis
[…] medical abortion with mifepristone and misoprostol was reported in 2001, in Canada.2 All three cases of C. sordellii infection were notable for lack of fever, and all had refractory hypotension, multiple effusions, hemoconcentration, and a profound leukocytosis [jamanetwork.com]
Laboratory findings include leukocytosis, thrombocytosis, elevated hematocrit, and significant hypoalbuminemia. The leukocytosis is usually profound, often exceeding 75,000 and with a remarkable left shift, which we observed in our patient. [hindawi.com]
[…] edit] The source of the bacteria has not been determined but it has been documented that about 0.5% to 10% of healthy women are lengthened vaginal carriage of C. sordellii.[2] There are several clinical features which are unique to C. sordellii: marked leukocytosis [en.wikipedia.org]
Treatment
At this time, vancomycin and clindamycin were added to her treatment regimen. [ncbi.nlm.nih.gov]
Prognosis
Beyond the presence of TcsL, several factors play an important role in overall prognosis, specifically, the site and nature of infection, immunocompromised state and antimicrobial resistance. [ncbi.nlm.nih.gov]
Etiology
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. [scielo.org.co]
From: cid.oxfordjournals.org [2] Etiology/Bacteriology Taxonomy | Domain = Bacteria | Phylum = Firmicutes | Class = Clostridia | Order = Clostridiales | Family = Clostridiaceae | Genus = Clostridium | species = Clostridium sordellii Description Clostridium [microbewiki.kenyon.edu]
Epidemiology
Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis 2006;43:1436–1446.CrossRefGoogle ScholarPubMed 2.Popoff, MR. [cambridge.org]
Stevens; Clostridium sordellii Infection: Epidemiology, Clinical Findings, and Current Perspectives on Diagnosis and Treatment; Clinical Infectious Diseases 2006; 43:1436-46 ^ Miech RP. [en.wikipedia.org]
What CDC is doing CDC experts in microbiology, epidemiology, and perinatology (pregnancy-related complications) are working together with state and local health agencies and the FDA in the investigation of recent deaths associated with C. sordellii. [cdc.gov]
Pathophysiology
Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005; 39:1483-8 ^ Nakamura S, Yamakawa K, Nishida S. Antibacterial susceptibility of Clostridium sordellii strains. [en.wikipedia.org]
Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005;39:1483–8. Cited Here 31. Golde S, Ledger WJ. Necrotizing fasciitis in postpartum patients. A report of four cases. [journals.lww.com]
Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005;39:1483-1488 38. Kruse B, Poppema S, Creinin MD, Paul M. Management of side effects and complications in medical abortion. [nejm.org]
Prevention
Prevention Prevention of a Clostridium sordellii infection is difficult with so little known about the transmission of the disease. [microbewiki.kenyon.edu]
Prevention and treatment of gas gangrene, JAMA, 1971, vol. 217 (pg. 806 - 1 ) 12 ., ,. [academic.oup.com]
Unsafe abortion: the preventable pandemic. Lancet. 2006; 368: 1908-1919 7. Grimes DA Unsafe abortion: the silent scourge. Br Med Bull. 2003; 67: 99-113 8. Bearak J Popinchalk A Ganatra B et al. [thelancet.com]
The Centers for Disease Control and Prevention (CDC) estimates that up to 29% of women who've undergone a medical abortion test positive for C. sordellii in vaginal fluid, compared with only 5% to 10% of women who aren't pregnant.1 (No figures are available [nursingcenter.com]
Older reports suggested that total hysterectomy32 or surgical debridement5 is necessary to remove necrotic tissue and prevent death in cases of C perfringens infection. [journals.lww.com]