Severe Sepsis due to Clostridium perfringens Bacteremia of Urinary Origin: A Case Report and Systematic Review

Abstract EN

Clostridium perfringens bacteremia is an uncommon yet serious clinical syndrome that typically arises from a gastrointestinal source.

However, clinicians should consider nongastrointestinal sources as well.

We present a rare case of C.

perfringens bacteremia of urinary origin that required surgical intervention for definitive treatment.

A 61-year-old male presented with acute nausea and vomiting, altered mental status, and chronic diarrhea.

His physical exam revealed right costovertebral tenderness and his laboratory work-up revealed acute renal failure.

Percutaneous blood cultures grew C.

perfringens.

Cross-sectional imaging revealed a right-sided ureteral stone with hydronephrosis, which required nephrostomy placement.

On placement of the nephrostomy tube, purulent drainage was identified and Gram stain of the drainage revealed Gram-variable rods.

A urinary source of C.

perfringens was clinically supported.

Although it is not a common presentation, nongastrointestinal sources such as a urinary source should be considered in C.

perfringens bacteremia because failure to recognize a nongastrointestinal source can delay appropriate treatment, which may include surgical intervention.