Document Detail


Clostridium septicum aortitis: Report of two cases and review of the literature.
MedLine Citation:
PMID:  19307090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clostridium septicum aortitis is a rare infection that has a strong association with occult colonic malignancy. To our knowledge, we report the 25th and 26th cases of C septicum aortitis in the English literature and make recommendations for its management. The first patient was a 75-year-old man who presented with abdominal pain. Computed tomography showed the presence of periaortic gas. He underwent aortic débridement and extra-anatomic bypass after blood cultures revealed C septicum. Four months after the initial presentation, he was readmitted with lethargy, found to have recurrent periaortic gas, and died. The second patient was a 76-year-old woman who presented with a 5-cm abdominal aortic aneurysm with surrounding retroperitoneal gas. She underwent emergency aortic ligation and retroperitoneal débridement. Her blood and intraoperative tissue cultures also grew C septicum. She had a prolonged postoperative course and ultimately died on hospital day 94. Both patients were found to have concurrent colon adenocarcinomas. C septicum aortitis is a lethal disease that necessitates prompt surgical intervention and appropriate antibiotic therapy. The strong association of C septicum with occult malignancy should prompt the astute clinician to undertake an exhaustive search for a neoplastic process.
Authors:
Christopher W Seder; Michael Kramer; Graham Long; Maciej R Uzieblo; Charles J Shanley; Paul Bove
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  49     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1304-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Section of General, Royal Oak, Mich., USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / complications*,  pathology,  surgery
Aged
Aged, 80 and over
Aneurysm, Infected / microbiology*,  radiography,  therapy
Anti-Bacterial Agents / therapeutic use
Aortic Aneurysm / microbiology*,  radiography,  therapy
Aortitis / microbiology*,  radiography,  therapy
Blood Vessel Prosthesis Implantation
Clostridium Infections / complications,  microbiology*,  radiography,  therapy
Clostridium septicum / isolation & purification*
Colonic Neoplasms / complications*,  pathology,  surgery
Debridement
Digestive System Surgical Procedures
Fatal Outcome
Female
Humans
Male
Middle Aged
Recurrence
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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