C. perfringens Blood Stream Infection due to Nontransmural Ischemia of the Esophagus, Stomach, and Left Colon: Case Report.

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Visceral Medicine Pub Date : 2023-06-01 Epub Date: 2023-06-12 DOI:10.1159/000530031
Johannes Reiner, Katharina Reichenbach, Imad Kamaleddine, Daniel Mokosch, Felix Streckenbach, Beate Brinkmann, Annette Pertschy, Maria Witte, Clemens Schafmayer, Marc-André Weber, Georg Lamprecht
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Abstract

We report the case of a 74-year-old female with abdominal pain, tarry stools, and tachycardia. Previous history included diabetes mellitus with micro- and macroangiopathy. Imaging revealed portal gas, left sided colitis, and emphysematous gastritis, besides severe atherosclerosis with subtotal celiac trunk occlusion and moderate stenosis of the inferior mesenteric artery. Upper endoscopy revealed findings consistent with focal necrotizing gastritis at the greater curvature and acute esophageal necrosis. Blood cultures immediately grew Clostridium perfringens. The patient was treated with broad spectrum antibiotics and was discharged after 21 days in the hospital. This case demonstrates the rare coincident occurrence of nontransmural ischemia of the left colon, the esophagus, and the stomach as a result of low-flow circulatory compromise, which then precipitated C. perfringens associated emphysematous gastritis and blood stream infection.

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食管、胃和左结肠非横纹肌缺血导致的C. perfringens血流感染:病例报告。
我们报告了一例 74 岁女性的病例,她患有腹痛、柏油样便和心动过速。既往病史包括糖尿病并发微血管和大血管病变。影像学检查发现门脉积气、左侧结肠炎和气肿性胃炎,此外还有严重的动脉粥样硬化,腹腔干次全闭塞和肠系膜下动脉中度狭窄。上内镜检查发现,大弯处有局灶性坏死性胃炎,食管急性坏死。血液培养立即培养出产气荚膜梭菌。患者接受了广谱抗生素治疗,住院 21 天后出院。该病例表明,由于低流量循环受损,左结肠、食管和胃同时发生非横纹肌缺血,进而诱发与产气荚膜梭菌相关的气肿性胃炎和血流感染,这种情况十分罕见。
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来源期刊
Visceral Medicine
Visceral Medicine Medicine-Surgery
CiteScore
4.50
自引率
0.00%
发文量
40
期刊介绍: This interdisciplinary journal is unique in its field as it covers the principles of both gastrointestinal medicine and surgery required for treating abdominal diseases. In each issue invited reviews provide a comprehensive overview of one selected topic. Thus, a sound background of the state of the art in clinical practice and research is provided. A panel of specialists in gastroenterology, surgery, radiology, and pathology discusses different approaches to diagnosis and treatment of the topic covered in the respective issue. Original articles, case reports, and commentaries make for further interesting reading.
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