Pulmonary Clostridium perfringens: Seeding Beyond the Gastrointestinal Tract.
Pulmonary Clostridium perfringens: Seeding Beyond the Gastrointestinal Tract.
- 2024
Clostridia perfringens infection outside the gastrointestinal system is rare. Here, we report on a 75-year-old man with history of end-stage renal disease presenting after a syncopal event with lactic acidosis, leukocytosis, and mild hyper-bilirubinemia. Chest imaging revealed a loculated, left-sided pleural effusion; diagnostic thoracentesis identified Clostridia perfringens, consistent with an empyema. Video-assisted thoracic left lung decortication was performed; tissue culture also speciated Clostridia perfringens. Further imaging revealed concomitant acute cholecystitis, suggesting hematogenous seeding or transdiaphragmatic extension of Clostridia perfringens to pleural space from an abdominal source. The patient was successfully managed with laparoscopic cholecystectomy and discharged on a one-month course of amoxicillin-sulbactam. This case highlights the potential for Clostridia perfringens to produce a pleuropulmonary infection, necessitating timely diagnosis and intervention, to improve patient outcomes. Copyright © 2024 Greater Baltimore Medical Center.
English
2000-9666
jchim-14-01-030 [pii] PMC10932497 [pmc]
--Automated
MedStar Franklin Square Medical Center
MedStar Union Memorial Hospital
Hospitalist
Infectious Diseases
Internal Medicine Residency
Medicine
Case Reports
Clostridia perfringens infection outside the gastrointestinal system is rare. Here, we report on a 75-year-old man with history of end-stage renal disease presenting after a syncopal event with lactic acidosis, leukocytosis, and mild hyper-bilirubinemia. Chest imaging revealed a loculated, left-sided pleural effusion; diagnostic thoracentesis identified Clostridia perfringens, consistent with an empyema. Video-assisted thoracic left lung decortication was performed; tissue culture also speciated Clostridia perfringens. Further imaging revealed concomitant acute cholecystitis, suggesting hematogenous seeding or transdiaphragmatic extension of Clostridia perfringens to pleural space from an abdominal source. The patient was successfully managed with laparoscopic cholecystectomy and discharged on a one-month course of amoxicillin-sulbactam. This case highlights the potential for Clostridia perfringens to produce a pleuropulmonary infection, necessitating timely diagnosis and intervention, to improve patient outcomes. Copyright © 2024 Greater Baltimore Medical Center.
English
2000-9666
jchim-14-01-030 [pii] PMC10932497 [pmc]
--Automated
MedStar Franklin Square Medical Center
MedStar Union Memorial Hospital
Hospitalist
Infectious Diseases
Internal Medicine Residency
Medicine
Case Reports