View source for Clostridium perfringens

== Background ==

===Microbiology===

*Often encapsulated short Gram-variable bacilli of varying length
*Found in soil and human (and animal) [[Gut microbiota|gut flora]]
*Makes necrotizing extracellular toxins
*Multiple types, based on production of major toxins, though only type A (and rarely type C) cause disease in humans
**Toxins include alpha-toxin (CPA), beta-toxin (CPB), epsilon-toxin (ETX), iota-toxin (ITX), enterotoxin (CPE), and necrotic enteritis B-like toxin (NetB)
{| class="wikitable"
!Type
!Toxins
!Clinical Notes
|-
|A
|CPA only
|foodborne illnesses associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel
|-
|C
|CPA and CPB ±CPE
|pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum), particularly in Papua New Guinea
|-
|all others
|Various
|do not cause disease in humans
|}

=== Epidemiology ===

* Spores can survive cooking at normal temperatures
* Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat

== Clinical Manifestations ==

* Acute infectious diarrhea
* Abdominal sepsis
* Cellulitis and myonecrosis

== Management ==

* For gas gangrene, typically requires surgical debridement and [[penicillin G]]
** Consider adding [[clindamycin]] for theoretical decreased toxin production in [[toxic shock syndrome]]
* Otherwise, generally susceptible to [[erythromycin]], [[chloramphenicol]], [[cefazolin]], [[cefoxitin]], [[ceftriaxone]], [[piperacillin]], [[carbapenems]], [[metronidazole]], [[vancomycin]], and [[linezolid]]
{{DISPLAYTITLE:''Clostridium perfringens''}}
[[Category:Gram-positive bacilli]]