Clostridium septicum

Background

Microbiology

• Gram-positive bacillus
• Member of the genus Clostridium
• Produces alpha toxin, which lyses neutrophils

Risk factors

• Associated with colon cancer or neutropenia
• Diabetes also a risk factor

Clinical Manifestations

• Can cause bacteremia and non-traumatic myonecrosis
• Clinical presentation is typically fulminant sepsis, which very high mortality

Management

• Aggressive surgical debridement, possibly including amputation
• Broad-spectrum antibiotics for necrotizing fasciitis are indicated until the microbiologic diagnosis is confirmed
• First-line antimicrobials are penicillin 2-4 million units IV q4h plus clindamycin 600-900 mg IV q6h