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A Case of Clostridium septicum Aortitis With Concomitant Adenocarcinoma of the Cecum.

Shah S, Whitehead D, Sampath K, Toor A - ACG Case Rep J (2015)

Bottom Line: Clostridium septicum aortitis is a rare infection that is strongly associated with underlying adenocarcinoma of the colon.Blood cultures grew Clostridium septicum.The patient was offered surgical intervention but refused; she was treated with antibiotics and discharged home where she died 1 week later.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

ABSTRACT
Clostridium septicum aortitis is a rare infection that is strongly associated with underlying adenocarcinoma of the colon. We report a case of a 73-year-old woman with peripheral vascular disease who presented after 4 weeks of severe abdominal pain. Abdominal computed tomography showed thickening of the cecal wall and gas in the aortic wall. Colonoscopy revealed a large ulcerated moderately differentiated adenocarcinoma in the cecum. Blood cultures grew Clostridium septicum. The patient was offered surgical intervention but refused; she was treated with antibiotics and discharged home where she died 1 week later.

No MeSH data available.


Related in: MedlinePlus

Abdominal and pelvic (A) sagittal and (B) transverse computed tomography angiography showing gas in the descending and thoracic abdominal aorta, approximately above the level of the celiac axis.
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Figure 1: Abdominal and pelvic (A) sagittal and (B) transverse computed tomography angiography showing gas in the descending and thoracic abdominal aorta, approximately above the level of the celiac axis.

Mentions: CT angiography demonstrated gas in the aortic wall proximal to the aortobifemoral bypass graft, with 2 focal outpouchings in the descending abdominal aorta, suspicious for an aortitis with a pseudoaneurysm (Figure 1). Additionally, there was a large area of cecal wall thickening with surrounding mesenteric fat stranding. Colonoscopy revealed a large, ulcerated circumferential mass in the cecum that, under microscopy, was found to be moderately differentiated adenocarcinoma (Figures 2 and 3). Blood cultures grew C. septicum. Definitive therapy (in consultation with infectious disease and vascular surgery consultants) required surgical intervention, but the patient's family opted for no surgical intervention or further antibiotic therapy. The patient was discharged home with hospice on hospital day 6, and died 1 week later.


A Case of Clostridium septicum Aortitis With Concomitant Adenocarcinoma of the Cecum.

Shah S, Whitehead D, Sampath K, Toor A - ACG Case Rep J (2015)

Abdominal and pelvic (A) sagittal and (B) transverse computed tomography angiography showing gas in the descending and thoracic abdominal aorta, approximately above the level of the celiac axis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508950&req=5

Figure 1: Abdominal and pelvic (A) sagittal and (B) transverse computed tomography angiography showing gas in the descending and thoracic abdominal aorta, approximately above the level of the celiac axis.
Mentions: CT angiography demonstrated gas in the aortic wall proximal to the aortobifemoral bypass graft, with 2 focal outpouchings in the descending abdominal aorta, suspicious for an aortitis with a pseudoaneurysm (Figure 1). Additionally, there was a large area of cecal wall thickening with surrounding mesenteric fat stranding. Colonoscopy revealed a large, ulcerated circumferential mass in the cecum that, under microscopy, was found to be moderately differentiated adenocarcinoma (Figures 2 and 3). Blood cultures grew C. septicum. Definitive therapy (in consultation with infectious disease and vascular surgery consultants) required surgical intervention, but the patient's family opted for no surgical intervention or further antibiotic therapy. The patient was discharged home with hospice on hospital day 6, and died 1 week later.

Bottom Line: Clostridium septicum aortitis is a rare infection that is strongly associated with underlying adenocarcinoma of the colon.Blood cultures grew Clostridium septicum.The patient was offered surgical intervention but refused; she was treated with antibiotics and discharged home where she died 1 week later.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

ABSTRACT
Clostridium septicum aortitis is a rare infection that is strongly associated with underlying adenocarcinoma of the colon. We report a case of a 73-year-old woman with peripheral vascular disease who presented after 4 weeks of severe abdominal pain. Abdominal computed tomography showed thickening of the cecal wall and gas in the aortic wall. Colonoscopy revealed a large ulcerated moderately differentiated adenocarcinoma in the cecum. Blood cultures grew Clostridium septicum. The patient was offered surgical intervention but refused; she was treated with antibiotics and discharged home where she died 1 week later.

No MeSH data available.


Related in: MedlinePlus