Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis
Joint Authors
Duncalf, Richard
Mishra, Rashmi
Sinha, Nupur
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-01-24
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Clostridium perfringens bacteremia is associated with adverse outcomes.
Known risk factors include chronic kidney disease, malignancy, diabetes mellitus, and gastrointestinal disease.
We present a 74-year-old man admitted with confusion, vomiting, and abdominal pain.
Exam revealed tachycardia, hypotension, lethargy, distended abdomen, and cold extremities.
He required intubation and aggressive resuscitation for septic shock.
Laboratory data showed leukocytosis, metabolic acidosis, acute kidney injury, and elevated lipase.
CT scan of abdomen revealed acute pancreatitis and small bowel ileus.
He was started on vancomycin and piperacillin-tazobactam.
Initial blood cultures were positive for C.
perfringens on day five.
Metronidazole and clindamycin were added to the regimen.
Repeat CT (day 7) revealed pancreatic necrosis.
The patient developed profound circulatory shock requiring multiple vasopressors, renal failure requiring dialysis, and bacteremia with vancomycin-resistant enterococci.
Hemodynamic instability precluded surgical intervention and he succumbed to multiorgan failure.
Interestingly, our isolate was beta lactamase producing.
We review the epidemiology, risk factors, presentation, and management of C.
perfringens bacteremia.
This case indicates a need for high clinical suspicion for clostridial sepsis and that extended spectrum beta lactam antibiotic coverage may be inadequate and should be supplemented with use of clindamycin or metronidazole if culture is positive, until sensitivities are known.
American Psychological Association (APA)
Mishra, Rashmi& Sinha, Nupur& Duncalf, Richard. 2016. Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis. Case Reports in Critical Care،Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1100445
Modern Language Association (MLA)
Mishra, Rashmi…[et al.]. Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis. Case Reports in Critical Care No. 2016 (2016), pp.1-4.
https://search.emarefa.net/detail/BIM-1100445
American Medical Association (AMA)
Mishra, Rashmi& Sinha, Nupur& Duncalf, Richard. Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis. Case Reports in Critical Care. 2016. Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1100445
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1100445