Clostridium Of The Abdomen And Pelvis

Clostridium, in particular Clostridium perfringens, often occur in intra-abdominal mixed infections due to a ruptured abdominal organ or pelvic inflammatory disease (PID, pelvic inflammatory disease).

Clostridial infections of the abdomen and pelvis are difficult and sometimes fatal.

Clostridium, in particular Clostridium perfringens, often occur in intra-abdominal mixed infections due to a ruptured abdominal organ or pelvic inflammatory disease (PID, pelvic inflammatory disease). Clostridial infections of the abdomen and pelvis are difficult and sometimes fatal. Clostridium sp. are common inhabitants of the gastrointestinal tract and occur in many abdominal infections, usually together with other enteric microorganisms. Clostridia are often the primary agent for the following diseases: A gas gangrene of the uterus (which may occur after childbirth and formerly occurred more frequently in patients who had a septic abortion) emphysematous cholecystitis Certain other infections of the female genital tract (tubo-ovariell-, pool – and uterine abscesses) infection after perforation in colon carcinoma the primary organisms are C. perfringens and, in the case of colon cancer, C. septicum. The pathogen produces exotoxins (lecithinases, haemolysines, collagenases, proteases and lipases), which can lead to pus formation. There is often a gas formation. A Clostridienseptikämie can lead to hemolytic anemia because lecithinases (?-toxin) destroys the red blood cell membrane. In severe hemolysis and simultaneous toxicity acute renal failure may occur. Symptoms and signs The symptoms resemble those of other abdominal infections (eg. As pain, fever, rebound tenderness, a toxic appearance). Patients with a uterine infection may suffer from a foul-smelling, bloody discharge and gas sometimes escapes through the cervix. Rarely has a tubular necrosis develops. Sepsis Sepsis can be a complication of intra-abdominal or uterine clostridial infections. Initial symptoms may be fever, chills, vomiting, diarrhea, abdominal pain, hypotension, tachycardia, jaundice, cyanosis and oliguria. 7 to 15% of patients with sepsis caused by C. perfringens an acute massive intravascular hemolysis occurs. These patients have jaundice and reddish it serum and urine. Spherocytes, ghost cells and sometimes C. perfringens can be seen in a stained blood smear. In some patients the blood culture for C. perfringens is positive. Clostridial sepsis can lead to multiple organ failure, which is often fatal, often within 24 hours to the hospital after admission. Diagnosis Gram stain and culture Early diagnosis requires an urgent clinical suspicion. Indicated are early and repeated Gram stains and cultures of the affected area as well as pus, lochia and blood. Since C. perfringens can occasionally be isolated from the healthy vagina and lochia from that culture is not specific. An X-ray examination can be applied to a local gas production point (z. B. biliary system, gall bladder wall or uterus). Therapy Surgical debridement High-dose penicillin Treatment consists of surgical debridement and penicillin G 5 million units iv every 6 h for at least 1 week. The removal of an organ (eg. B. hysterectomy) may be necessary and even be life saving when a debridement is not sufficient. If acute tubular necrosis develops, dialysis is required. The benefit of hyperbaric O2 therapy is not been established.

Health Life Media Team

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