Abstract：
BACKGROUND:Necrotizing Clostridium septicum infections (CSI) have a strong association with malignancy or immunosuppression. To clarify this relationship and determine how it impacted mortality, the experience with CSI at a single institution was reviewed. METHODS:Records of all patients admitted to our hospital with culture proven clostridial infection from 1966 through 1993 were reviewed. RESULTS:Among patients presenting with clinical gas gangrene, 281 had culture proven clostridial infection and 32 (11.4%) had CSI. The mortality among CSI patients was 56%, whereas 26% of all patients with clostridial infections died (p = 0.001). An associated malignancy was found in 50% of patients with CSI, whereas this was seen in only 11% of patients with other clostridial infections (p = 0.0001 for CSI versus clostridial infection overall). The remaining patients with spontaneous CSI all had evidence of immunosuppression. CONCLUSIONS:The high mortality and likelihood of associated malignancy or hematologic disease underscore the importance of a high index of suspicion and the need to search for and treat associated conditions in all patients with CSI.
journal_name
Surgeryjournal_title
Surgeryauthors
Larson CM,Bubrick MP,Jacobs DM,West MAdoi
10.1016/s0039-6060(05)80023-6subject
Has Abstractpub_date
1995-10-01 00:00:00pages
592-7; discussion 597-8issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(05)80023-6journal_volume
118pub_type
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