Pig-bel but no pig: enteritis necroticans acquired in Australia.
OBJECTIVE
To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.


METHODS
A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.


RESULTS
He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.


CONCLUSIONS
Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.
Watson
D A
DA
St Vincent's Hospital, Fitzroy, VIC.
Andrew
J H
JH
Banting
S
S
Mackay
J R
JR
Stillwell
R G
RG
Merrett
M
M
D000328:Adult; D000900:Anti-Bacterial Agents; D001315:Australia; D002681:China / Q000208:ethnology; D003015:Clostridium Infections / Q000175:diagnosis; D003016:Clostridium perfringens; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004751:Enteritis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D005243:Feces / Q000382:microbiology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D008296:Malaysia / Q000208:ethnology; D008297:Male; D009336:Necrosis
D000900:Anti-Bacterial Agents