Clostridium septicum Infection and Malignancy

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Abstract
Seven patients with C. septicum gangrene or sepsis were treated at a hospital from 1977-79. All of these patients had associated malignant disease: 4 patients had colon adenocarcinomas, 2 patients had acute myeloblastic leukemias and 1 patient had breast carcinoma. In 6 of the 7 patients, the malignancy was in an advanced state; the breast carcinoma showed no evidence of recurrence after mastectomy, 17 yr earlier. A bowel portal of entry is postulated in 5 patients. Despite prompt use of appropriate antibiotics, the only survivors were 2 of the 4 patients, who underwent early extensive debridement. These results suggest that in the patients with C. septicum infection, malignancy should be sought; that, in the septic patient with known malignancy, C. septicum should be considered; and that, in the absence of external source in the patient with clostridial myonecrosis or sepsis, the cecum or distal ileum should be considered a likely site of infection. Increased awareness of this association between C. septicum and malignancy, and aggressive surgical treatment, may result in improvement in the present 50-70% mortality rate.

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