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Necrotizing pneumonia and sepsis due to Clostridium perfringens: a case report.

Palmacci C, Antocicco M, Bonomo L, Maggi F, Cocchi A, Onder G - Cases J (2009)

Bottom Line: Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura.The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal.We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Geriatrics, Policlinico A, Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. graziano_onder@rm.unicatt.it.

ABSTRACT
Clostridia are uncommon causes of pleuropulmonary infection. Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura. Most cases have iatrogenic causes usually due to invasive procedures into the pleural cavity, such as thoracentesis or thoracotomy, or penetrating chest injuries. Rarely clostridia pleuropulmonary infections are not related to these factors. The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal. We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman.

No MeSH data available.


Related in: MedlinePlus

Contrast-enhanced multi-slice CT of the thorax performed 48 hours after admission. Multi-slice CT of the thorax confirmed presence of bilateral pleural effusion and consolidation of lower lobes and lingula; cavitation was revealed in the pleural-based consolidation of the lingula (Figure 2A-B, white arrows) and in the right lower lobe (Figure 2A-C-D, black arrows). These findings were considered indicative of a necrotizing, gangrenous pneumonia.
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Figure 1: Contrast-enhanced multi-slice CT of the thorax performed 48 hours after admission. Multi-slice CT of the thorax confirmed presence of bilateral pleural effusion and consolidation of lower lobes and lingula; cavitation was revealed in the pleural-based consolidation of the lingula (Figure 2A-B, white arrows) and in the right lower lobe (Figure 2A-C-D, black arrows). These findings were considered indicative of a necrotizing, gangrenous pneumonia.

Mentions: The chest X-ray showed aspecific findings of bilateral pleural effusion with consolidation of lower lobes and lingula. It was therefore undertaken oxygen therapy, hydrating, diuretic and empirical antibiotic therapy with cephalosporins and macrolides and blood cultures were performed. After 48 hours, a multislice CT scan of the chest was performed, which confirmed bilateral pleural effusion and consolidation of lower lobes and lingula; in right lower lobe and lingula areas of cavitation were also demonstrated, suggesting the hypothesis of a necrotizing, gangrenous pneumonia (Figure 1). An abdominal ultrasound did not show any relevant finding.


Necrotizing pneumonia and sepsis due to Clostridium perfringens: a case report.

Palmacci C, Antocicco M, Bonomo L, Maggi F, Cocchi A, Onder G - Cases J (2009)

Contrast-enhanced multi-slice CT of the thorax performed 48 hours after admission. Multi-slice CT of the thorax confirmed presence of bilateral pleural effusion and consolidation of lower lobes and lingula; cavitation was revealed in the pleural-based consolidation of the lingula (Figure 2A-B, white arrows) and in the right lower lobe (Figure 2A-C-D, black arrows). These findings were considered indicative of a necrotizing, gangrenous pneumonia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2648949&req=5

Figure 1: Contrast-enhanced multi-slice CT of the thorax performed 48 hours after admission. Multi-slice CT of the thorax confirmed presence of bilateral pleural effusion and consolidation of lower lobes and lingula; cavitation was revealed in the pleural-based consolidation of the lingula (Figure 2A-B, white arrows) and in the right lower lobe (Figure 2A-C-D, black arrows). These findings were considered indicative of a necrotizing, gangrenous pneumonia.
Mentions: The chest X-ray showed aspecific findings of bilateral pleural effusion with consolidation of lower lobes and lingula. It was therefore undertaken oxygen therapy, hydrating, diuretic and empirical antibiotic therapy with cephalosporins and macrolides and blood cultures were performed. After 48 hours, a multislice CT scan of the chest was performed, which confirmed bilateral pleural effusion and consolidation of lower lobes and lingula; in right lower lobe and lingula areas of cavitation were also demonstrated, suggesting the hypothesis of a necrotizing, gangrenous pneumonia (Figure 1). An abdominal ultrasound did not show any relevant finding.

Bottom Line: Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura.The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal.We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Geriatrics, Policlinico A, Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. graziano_onder@rm.unicatt.it.

ABSTRACT
Clostridia are uncommon causes of pleuropulmonary infection. Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura. Most cases have iatrogenic causes usually due to invasive procedures into the pleural cavity, such as thoracentesis or thoracotomy, or penetrating chest injuries. Rarely clostridia pleuropulmonary infections are not related to these factors. The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal. We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman.

No MeSH data available.


Related in: MedlinePlus