Case report

Clostridium septicum sepsis and colorectal cancer - a reminder

Nazzia N Mirza , Jonathon M McCloud and Mark J Cheetham

Department of Surgery, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, UK

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World Journal of Surgical Oncology 2009, 7:73doi:10.1186/1477-7819-7-73

Published:	6 October 2009

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.

Case Presentation

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.

Conclusion

Although uncomman, 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.