Abstract
A mycotic aneurysm caused by a Clostridium septicum is a rare infection and has a strong association with colorectal cancer. If left untreated, the mortality rate of the first 24 h is high. This case report discusses the optimal treatment of emergency surgery combined with antibiotic treatment to improve survival. We present a fatal case of a 71-year-old male with abscedation of a caecal carcinoma who shortly after developed a mycotic aneurysm of the infrarenal aorta as a result of a C. septicum infection.
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Bodey GP, Rodriguez S, Fainstein V, Elting LS. Clostridial bacteremia in cancer patients. A 12-year experience. Cancer. 1991;67:1928–42.
Smith-Slatas CL, Bourque M, Salazar JC. Clostridium septicum infections in children: a case report and review of the literature. Pediatrics. 2006;117:796–805.
Kopliku FA, Schubert AM, Mogle J, Schloss PD, Young VB, Aronoff DM. Low prevalence of Clostridium septicum fecal carriage in an adult population. Anaerobe. 2015;32:34–6.
Kennedy CL, Krejany EO, Young LF, O’Connor JR, Awad MM, Boyd RL, et al. The alpha-toxin of Clostridium septicum is essential for virulence. Mol Microbiol. 2005;57:1357–66.
Kennedy CL, Lyras D, Cordner LM, Melton-Witt J, Emmins JJ, Tweten RK, et al. Pore-forming activity of alpha-toxin is essential for Clostridium septicum-mediated myonecrosis. Infect Immun. 2009;77:943–51.
Schaaf RE, Jacobs N, Kelvin FM, Gallis HA, Akwari O, Thompson WM. Clostridium septicum infection associated with colonic carcinoma and hematologic abnormality. Radiology. 1980;137:625–27.
Seder CW, Kramer M, Long G, Uzieblo MR, Shanley CJ, Bove P. Clostridium septicum aortitis: report of two cases and review of the literature. J Vasc Surg. 2009;49:1304–09.
Jendrzejewski JW, Jones SR, Newcombe RL, Gilbert DN. Nontraumatic clostridial myonecrosis. Am J Med. 1978;65:542–6.
Ito F, Inokuchi R, Matsumoto A, Kumada Y, Yokoyama H, Ishida T, et al. Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature. J Med Case Rep. 2017. https://doi.org/10.1186/s13256-017-1422-0.
Kornbluth AA, Danzig JB, Bernstein LH. Clostridium septicum infection and associated malignancy. Report of 2 cases and review of the literature. Medicine (Baltim). 1989;68:30–7.
Alimi Y, Sosin M, Borsinger TM, et al. Implications of Clostridium septicum in vascular surgery: a case report and outcomes literature review. Ann Vasc Surg. 2017 Aug;43:314.e5–314.e11.
Müller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W, et al. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extraanatomic repair in 33 cases. J Vasc Surg. 2001;33:106–13.
Ting AC, Cheng SW, Ho P, Poon JT, Tsu JH. Surgical treatment of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta. Am J Surg. 2005;189:150–4.
Hernandez-Richter T, Schardey HM, Wittmann F, Mayr S, Schmitt-Sody M, Blasenbreu S, et al. Rifampin and Triclosan but not silver is effective in preventing bacterial infection of vascular dacron graft material. Eur J Vasc Endovasc Surg. 2003;26:550–7.
Young RM, Cherry KJ Jr, Davis PM, Gloviczki P, Bower TC, Panneton JM, et al. The results of in situ prosthetic replacement for infected aortic grafts. Am J Surg. 1999;178:136–40.
Weis-Muller BT, Rascanu C, Sagban A, Grabitz K, Godehardt E, Sandmann W. Single-center experience with open surgical treatment of 36 infected aneurysms of the thoracic, thoracoabdominal, and abdominal aorta. Ann Vasc Surg. 2011;25:1020–5.
Stevens DL, Aldape MJ, Bryant AE. Life-threatening clostridial infections. Anaerobe. 2012;18(2):254–9.
Stevens DL, Laine BM, Mitten JE. Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens. Antimicrob Agents Chemother. 1987;31:312–6.
Stevens DL, Maier KA, Mitten JE. Effect of antibiotics on toxin production and viability of Clostridium perfringens. Antimicrob Agents Chemother. 1987;31:213–8.
Stevens DL, Bryant AE, Hackett SP. Antibiotic effects on bacterial viability, toxin production, and host response. Clin Infect Dis. 1995;20:154–7.
Hollier LH, Money SR, Creely B, Bower TC, Kazmier FJ. Direct replacement of mycotic thoracoabdominal aneurysms. J Vasc Surg. 1993;18:477–84.
Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams TW Jr. In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg. 1989;47:193–203.
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Ramphal, W., Raaijmakers, N.J., van der Klift, M. et al. Mycotic aneurysm caused by Clostridium septicum in a patient with colorectal cancer. Infection 46, 711–716 (2018). https://doi.org/10.1007/s15010-018-1155-z
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DOI: https://doi.org/10.1007/s15010-018-1155-z