Clostridium innocuum bacteremia secondary to infected hematoma with gas formation in a kidney transplant recipient.
Clostridium innocuum is a relatively antimicrobial resistant, frequently misidentified anaerobe that has only rarely been associated with bacteremia. A 38-year-old female with chronic hepatitis C underwent a second kidney transplant operation. Two weeks after surgery a computed tomography scan of the abdomen showed a heterogeneous hematoma with pockets of gas adjacent to the allograft, which extended into the pelvis and left abdominal wall, associated with low-grade fever. An anaerobic blood culture grew a Clostridium initially identified as C. subterminale and later re-identified as C. innocuum. At abdominal exploration liquefied blood was evacuated, and the patient completed a course of antibiotics and recovered. C. innocuum should be considered as a cause of gas-producing anaerobic infection in transplant patients. Because C. innocuum is frequently misidentified by the use of commercial anaerobic identification kits, its true incidence in serious infections is likely underestimated.
Castiglioni
B
B
Department of Surgery, University of Pittsburgh Medical Center, The Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania 15213, USA.
Gautam
A
A
Citron
D M
DM
Pasculle
W
W
Goldstein
E J C
EJ
Strollo
D
D
Jordan
M
M
Kusne
S
S
D000328:Adult; D016470:Bacteremia / Q000209:etiology*; D003013:Clostridium / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000209:etiology*; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous