title: Clostridium Sordellii as an Uncommon Cause of Fatal Toxic Shock Syndrome in a Postpartum 33-Year-Old Asian Woman, and the Need for Antepartum Screening for This Clostridia Species in the General Female Population.
abstract: Clostridium sordellii (C. sordellii) is an anaerobic gram-positive rod most commonly found in the soil and sewage but also as part of the normal flora of the gastrointestinal tract and vagina of a small percentage of healthy individuals. C. sordellii infection is considered to result from childbirth, abortion, and/or gynecological procedures. Although many strains of C. sordellii are nonpathogenic, virulent toxin-producing strains exist. Infection with this organism typically manifests as a patient experiencing septic shock rapidly followed by end-organ failure. Identification of C. sordelli has been successful by traditional culture, mass spectrometry methods, and via molecular methods. Herein, we present a fatal case of C. sordellii infection of a postpartum 33-year-old Asian woman. The organism was isolated by culture and identified using matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) technology. With the advent of rapid detection methods, antepartum screening for the fatal Clostridium species should be implemented in the general female population.
authors.affiliation: Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY melissaguzzetta@gmail.com.
authors.forename: Melissa
authors.initials: M
authors.lastname: Guzzetta
authors.affiliation: Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY melissaguzzetta@gmail.com.
authors.forename: Alex
authors.initials: A
authors.lastname: Williamson
authors.affiliation: Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY.
authors.forename: Scott
authors.initials: S
authors.lastname: Duong
mesh_terms: D000328:Adult; D044466:Asian People; D001431:Bacteriological Techniques; D003015:Clostridium Infections / Q000150:complications* / Q000175:diagnosis*; D047989:Paraclostridium sordellii / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D049590:Postpartum Period; D011295:Prenatal Care / Q000379:methods; D012772:Shock, Septic / Q000209:etiology* / Q000473:pathology*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
keywords: childbirth complications; clostridium sordellii; episiotomy infections; postpartum infections; rare clostridial infections; toxic shock syndrome