Srivastava Ira, Aldape Michael J, Bryant Amy E, Stevens Dennis L
Boise VA Medical Center, Boise, ID 83702, USA.
Boise VA Medical Center, Boise, ID 83702, USA.
Anaerobe. 2017 Dec;48:165-171. doi: 10.1016/j.anaerobe.2017.07.008. Epub 2017 Aug 2.
As the infectious disease paradigm undergoes a subtle shift, unusual infections associated with malignancy and immunosuppression are being increasingly reported. Spontaneous or non-traumatic Clostridium septicum infection is one such unusual infection which has gained prominence. This article aims to understand the pathophysiology, clinical manifestations and current trends in diagnosing and treating this rare but deadly infection. To understand the multifactorial causation of this infection a review of published cases of spontaneous C. septicum gas gangrene was performed and a total of 94 such cases were identified. Several factors were analyzed for each case: age, infection location and underlying illness, presenting signs and symptoms, neutropenia, gross pathology of the colon, antibiotic use, surgical intervention, and survival. A known or occult malignancy was present in 71% patients and an overall mortality of 67% was observed.
随着传染病模式发生微妙转变，与恶性肿瘤和免疫抑制相关的不寻常感染报告越来越多。自发性或非创伤性败血梭菌感染就是这样一种备受关注的不寻常感染。本文旨在了解这种罕见但致命感染的病理生理学、临床表现以及诊断和治疗的当前趋势。为了解这种感染的多因素病因，我们对已发表的自发性败血梭菌气性坏疽病例进行了回顾，共识别出94例此类病例。对每个病例分析了几个因素：年龄、感染部位和基础疾病、呈现的体征和症状、中性粒细胞减少、结肠大体病理学、抗生素使用、手术干预和生存情况。71%的患者存在已知或隐匿性恶性肿瘤，总体死亡率为67%。
