title: Case of Clostridium perfringens bacteremia after routine colonoscopy and polypectomy.
abstract: Bacteremia is an uncommon complication after polypectomy and colonoscopy. We report one of the first cases of Clostridium perfringens bacteremia after polypectomy. Our patient was a four years old boy with congenital polyposis, who underwent colonoscopy and polypectomy without complication. Approximately 12h later he developed a fever and tachycardia with no other clinical symptoms. His blood cultures grew out penicillin susceptible C. perfringens and Enterococcus faecalis. He responded to antibiotic therapy and remained clinically asymptomatic for the duration of his course. There are a few reports of bacteremia after routine polypectomy, but no reported cases of C. perfringens bacteremia in the pediatric population. Clostridial sp. bacteremia can be fatal with devastating consequences if appropriate antibiotics and/or surgical debridement are delayed. Polymicrobial infection, as illustrated in our patient, is also common and can be a poor prognostic risk factor. Therefore, for patients with a history of polypectomy and new onset fever, anaerobic infections should be considered and empiric antibiotic therapy should include coverage for these organisms.
authors.affiliation: Walter Reed Army Medical Center, Department of Pediatrics MCHL-K 6900 Georgia Avenue, NW Washington DC 20307, USA. kdocs2002@verizon.net
authors.forename: Anjali N
authors.initials: AN
authors.lastname: Kunz
authors.forename: Diana
authors.initials: D
authors.lastname: Riera
authors.forename: Patrick
authors.initials: P
authors.lastname: Hickey