Clostridium septicum abscess in hepatic metastases: successful medical management.
Clostridium septicum bacteremia is frequently associated with hematologic and colonic malignancies and neutropenia. It frequently produces 'metastatic' gangrene with excessive mortality. Standard therapy usually includes surgical debridement and antibiotics. We present a patient with metastatic breast cancer treated with high-dose chemotherapy and bone marrow transplantation. She was treated successfully with antibiotics alone despite developing Cl. septicum bacteremia and gas in hepatic metastases. The pathophysiology of this infection is reviewed.
Thel
M C
MC
Division of Cardiology, Duke University Medical Center, Durham, NC 27710.
Ciaccia
D
D
Vredenburgh
J J
JJ
Peters
W
W
Corey
G R
GR
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002330:Carmustine / Q000008:administration & dosage; D002442:Ceftazidime / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D002981:Clindamycin / Q000627:therapeutic use; D003015:Clostridium Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005740:Gases; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D016867:Immunocompromised Host; D008100:Liver Abscess / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary*; D008727:Methotrexate / Q000008:administration & dosage; D009503:Neutropenia / Q000209:etiology / Q000628:therapy; D018805:Sepsis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology
D005740:Gases; D016179:Granulocyte Colony-Stimulating Factor; D002981:Clindamycin; D005047:Etoposide; D015378:Imipenem; D004317:Doxorubicin; D003520:Cyclophosphamide; D002442:Ceftazidime; D002945:Cisplatin; D005472:Fluorouracil; D002330:Carmustine; D008727:Methotrexate