title: Clostridium septicum sepsis and colorectal cancer - a reminder.
abstract: BACKGROUND
  Spontaneous clostridium septicum infections are rare and are associated with a high mortality. Association of clostridium infection with colorectal malignancies have been previously reported and most cases are described in tumours of the ascending colon. We report our experience of clostridium septicum infection in the presence of tumour perforation in a series of two patients as a reminder of its association with sepsis in the presence of colorectal malignancy.
  
  
  METHODS
  We isolated clostridium septicum infection in a series of two patients admitted as emergencies. One patient was found to have a perforated caecal tumour intraoperatively whilst the other had a perforated rectal tumour. The clinical outcome and management of each case are reported and underlying reasons for variations in outcome are discussed.
  
  
  CONCLUSIONS
  Although uncommon, the possibility of clostridium septicum sepsis should be borne in mind in patients who present with underlying malignancy and have sepsis. The cumulative effect of sepsis and malignant perforation is associated with a high morbidity and mortality. Awareness and early diagnosis of clostridium septicum may improve the prognosis of what is usually regarded as a fatal infection.
authors.affiliation: Department of Surgery, Royal Shrewsbury Hospital, Shrewsbury, UK. n.n.mirza.1@bham.ac.uk
authors.forename: Nazzia N
authors.initials: NN
authors.lastname: Mirza
authors.forename: Jonathon M
authors.initials: JM
authors.lastname: McCloud
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Cheetham
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002432:Cecum / Q000382:microbiology / Q000473:pathology; D003015:Clostridium Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D052557:Clostridium septicum / Q000302:isolation & purification*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000382:microbiology; D012007:Rectum / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents