CME Journal of Medical Microbiology
ISSN: 3070-3638 | DOI: 10.64030/3070-3638
Malvina Javakhadze, Alexandre Tavartkiladze, Nana Dzneladze, Nana Mgaloblishvili, Maia Kherkheulidze, Irma Korinteli, Baka Dangadze, Tamar Kachibaia and Tamar Gegeshidze
Introduction Clostridium septicum can cause spontaneous, atraumatic myonecrosis and rapidly progressive sepsis with high case fatality despite timely antimicrobials. Early surgical source control and toxin�??suppressive therapy are crucial.
Case presentation A 70�??year�??old Caucasian (White) woman presented with abrupt right upper�??limb pain and swelling that progressed within hours to bullae and subcutaneous emphysema. Arterial/venous duplex and CT angiography excluded occlusion. On arrival she was borderline hypotensive with oxygen desaturation. Laboratory studies showed leukocytosis (15.79×10⁹/L), marked procalcitonin (51.43 ng/mL), coagulopathy, severe lactic acidosis (10.7 mmol/L), and thrombocytopenia (111×10⁹/L). Transthoracic echocardiography revealed severe LV hypertrophy with reduced EF (35%). Anaerobic blood culture grew C. septicum. Despite early broad�??spectrum antibiotics, escalating vasopressors, and mechanical ventilation, she developed refractory shock; surgery was deemed unfeasible due to profound instability. She died 19 hours after symptom onset.
Conclusions This case underscores the hyper�??acute trajectory of C. septicum sepsis, the potential for minimal early fever, and the necessity of immediate surgical consultation plus toxin�??suppressive coverage (e.g., addition of clindamycin) alongside broad anaerobic therapy. Detection of C. septicum bacteremia should trigger urgent oncologic evaluation for occult malignancy.