Clostridium septicum and malignancy.
BACKGROUND
Clostridium septicum is known to be associated with malignancy or immunosuppression. It has a variable clinical presentation and is associated with a high mortality. The aim of the present study was to review the experience at St George Hospital, Sydney, over a 10-year period, with particular reference to the association of this condition with colorectal cancer.


METHODS
The records of five patients with blood culture-proven Clostridium septicum infection, among a larger group of 31 patients with clostridial infections, presenting to St George Hospital between 1990 and 2000 were reviewed.


RESULTS
Associated malignancy was found in four (80%) of the patients with Clostridium septicum infection. Two infections were related to colorectal cancer, two to haematological malignancies and one to radiation-induced recto-urethral fistula. Those patients who had colorectal cancer presented with septicaemia and vague abdominal symptoms.


CONCLUSIONS
Clostridium septicum infections have a strong association with malignancy. When this infection occurs without an obvious underlying aetiology there should be a high index of suspicion about associated malignancy. In the absence of haematological malignancy a colonoscopy is warranted. Early diagnosis and aggressive treatment is essential in order to improve prognosis.
Chew
S S
SS
Colorectal Surgical Unit, St George Hospital, Sydney, New South Wales, Australia.
Lubowski
D Z
DZ
D000328:Adult; D000368:Aged; D003013:Clostridium / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000382:microbiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000382:microbiology; D012189:Retrospective Studies; D014522:Urethral Diseases / Q000382:microbiology; D014548:Urinary Fistula / Q000382:microbiology