Clostridium septicum abscess in hepatic metastases: successful medical management

Bone Marrow Transplant. 1994 Apr;13(4):495-6.

Abstract

Clostridium septicum bacteremia is frequently associated with hematologic and colonic malignancies and neutropenia. It frequently produces 'metastatic' gangrene with excessive mortality. Standard therapy usually includes surgical debridement and antibiotics. We present a patient with metastatic breast cancer treated with high-dose chemotherapy and bone marrow transplantation. She was treated successfully with antibiotics alone despite developing Cl. septicum bacteremia and gas in hepatic metastases. The pathophysiology of this infection is reviewed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Carmustine / administration & dosage
  • Ceftazidime / therapeutic use
  • Cisplatin / administration & dosage
  • Clindamycin / therapeutic use
  • Clostridium Infections / complications*
  • Clostridium Infections / drug therapy
  • Clostridium Infections / physiopathology
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Drug Therapy, Combination / therapeutic use*
  • Etoposide / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Gases
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Imipenem / therapeutic use
  • Immunocompromised Host
  • Liver Abscess / complications*
  • Liver Abscess / drug therapy
  • Liver Abscess / microbiology
  • Liver Abscess / physiopathology
  • Liver Neoplasms / complications
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary*
  • Methotrexate / administration & dosage
  • Neutropenia / etiology
  • Neutropenia / therapy
  • Sepsis / complications
  • Sepsis / diagnosis
  • Sepsis / microbiology

Substances

  • Gases
  • Granulocyte Colony-Stimulating Factor
  • Clindamycin
  • Etoposide
  • Imipenem
  • Doxorubicin
  • Cyclophosphamide
  • Ceftazidime
  • Cisplatin
  • Fluorouracil
  • Carmustine
  • Methotrexate