Diagnosis and treatment challenges in a rare Clostridium infection: A case report

• Published in: Biomedical reports Vol. 21; no. 5; p. 149
• Main Authors: Bălaș-Maftei, Bianca, Florea, Carmen-Elena, Obreja, Maria, Rotaru, Alexandra, Miftode, Larisa, Miftode, Egidia, Irimie-Băluță, Erika-Raluca, Manciuc, Carmen
• Format: Journal Article
• Language: English
• Published: England Spandidos Publications UK Ltd 01.11.2024; D.A. Spandidos
• Subjects: Abdomen; Alcohol; Anaerobic conditions; Anaerobic treatment; Antibiotics; Bacteremia; Bacteria; Bacterial infections; Carbapenems; Case Report; Case reports; Clostridium; Clostridium paraputrificum; Creatinine; Diabetes mellitus; Emergency medical care; Gastrointestinal diseases; Gram-positive bacteria; Hospitals; Infections; Infectious diseases; Intestinal microflora; Malignancy; Meningitis; Metronidazole; Nephrology; Neutropenia; Penicillin; Pneumonia; Rare species; Sepsis; Septic shock; Tetanus; Toxins; Romania; Clostridium paraputrificum; septic shock; carbapenems; fluoroquinolones; antibiotic resistance
• ISSN: 2049-9434; 2049-9442; 2049-9442
• DOI: 10.3892/br.2024.1837

The genus includes >180 species of Gram-positive, anaerobic, sporulating bacteria. Under certain conditions, these can cause a wide range of invasive infections in humans. occurs in the commensal intestinal flora and related bacteremia typically occurs secondary to an injury to the intestinal mucosa and in the presence of predisposing conditions, such as gastrointestinal disorders, malignancies, diabetes, HIV infection or neutropenia. The current study presents the case of a 70-year-old male patient, a rural resident living in poverty, with a history of alchohol consumption and cardiovascular pathology. Several initial and subsequent diagnoses were ruled out by successive investigations (e.g., stroke, meningitis, localized tetanus). Blood cultures were eventually found positive for and the patient developed septic shock despite treatment with metronidazole and penicillin G. Once switched to carbapenem, the patient progressed favorably, suggesting that carbapenem could work as a first-line antibiotic treatment for infections.