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 Release 21.0, Jan 2008
 
Chapter : ch23. Microbiology & Infectious Diseases Section : Evaluation of Bacteremias and Sepsis
  Clinical Findings in a Patient with Clostridium sordellii Bacteremia

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Overview :

Clostridium sordellii bacteremia is a life-threatening illness that may be difficult to diagnose initially.

 

Onset of symptoms: 2 to 7 days after inciting event (if identified)

 

Clinical findings:

(1) hypotension progressing to shock

(2) afebrile

(3) nausea and vomiting

(4) dizziness

(5) generalized weakness with lethargy

(6) diarrhea

(7) chills

(8) marked tachycardia

(9) peripheral edema, pulmonary edema, pleural effusions and ascites

(10) mild pain at sites of infection

 

The lack of fever may be misleading and delay diagnosis.

 

Laboratory findings:

(1) very high white blood cell count (leukemoid reaction)

(2) low serum albumin and total protein

(3) hemoconcentration with high hematocrit

(4) thrombocytopenia

(5) metabolic acidosis

(6) elevated creatinine with renal failure

(7) hypoxemia with respiratory failure

 

Poor prognostic findings:

(1) septic shock with multi-organ failure

(2) leukemoid reaction with WBC > 75,000 per µL

(3) capillary leak syndrome very low serum albumin (<= 1.0 g/dL)

 

Mortality rate: 50 - 70%, typically 2-6 days after onset of symptoms

 

  References:

Aldape MJ, Bryant AE, Stevens DL. Clostridium sordellii infection: Epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis. 2006; 43: 1436-1446.

 

 

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