Mortality correlated with both shock and leukemoid reaction at presentation. We present a case of C. sordellii sepsis in an asplenic patient with sickle beta thalassemia and inflammatory bowel disease, and we review the literature. [pubmed.ncbi.nlm.nih.gov]

C. sordellii, a pathogen that is infrequently found in humans, has a broad spectrum of clinical presentations. [academic.oup.com]

The patient presented for medical abortion at 19 weeks of gestation. [journals.lww.com]

The patient died during the surgical procedure, approximately 23 hours after her initial presentation to the hospital. [nejm.org]

Paper presented at: 16th Annual Meeting of the Society for Healthcare Epidemiology of America, March 18-21,2006; Chicago, IL.Google Scholar 6.Lynch, JM, Anderson, A, Camacho, FR, Winters, AK, Hodges, GR, Barnes, WG. [cambridge.org]

• Hypoxemia

  Refractory bradycardia, hypotension, and hypoxemia developed, and the patient died approximately 10 hours after admission. [nejm.org]

• Pneumonia

  Clostridiaceae Genus: Clostridium Species: C. pasteurianum Binomial name Clostridium sordellii (Hall and Scott, 1927) Prévot, 1938 Clostridium sordellii is a rare anaerobic, gram-positive, spore-forming rod with peritrichous flagella that is capable of causing pneumonia [en.wikipedia.org]

  Transmission of C. sordellii infection What CDC is doing Additional Information General Information about C. sordellii Clostridium sordellii [klaw–strĭ–dee–um sore–dell–ee–i] (also called C. sordellii) is a rare bacterium that causes pneumonia, endocarditis [cdc.gov]

  Clostridium sordellii has been reported to cause a variety of diseases including peritonitis, endocarditis, pneumonia, arthritis, cellulitis, and myonecrosis [1–4]. [hindawi.com]

  C. sordellii is an infrequent human pathogen but has been reported as a cause of pneumonia, endocarditis, arthritis, peritonitis, and myonecrosis.1,15-17 C. sordellii bacteremia and sepsis occur rarely, primarily among patients with serious underlying [nejm.org]

• Abdominal Pain

  Five days after taking oral mifepristone, the patient presented to an emergency department with abdominal pain. [journals.lww.com]

  Most of their signs and symptoms were typical of sepsis and TSS: tachycardia, hypotension, leukocytosis, hemoconcentration, weakness, vomiting, abdominal pain, and diarrhea. [nursingcenter.com]

  Symptoms of C. sordellii infection Symptoms of a C. sordellii infection include nausea, vomiting, diarrhea, and sometimes abdominal pain without fever. [cdc.gov]

  Five days after receiving mifepristone, she presented to a local emergency department reporting nausea, vomiting, diarrhea, and severe abdominal pain. [nejm.org]

  In August 2001, a 26-year-old, previously healthy woman was hospitalized because of abdominal pain, vomiting, and foul-smelling vaginal discharge. [academic.oup.com]

• Nausea

  Symptoms of C. sordellii infection Symptoms of a C. sordellii infection include nausea, vomiting, diarrhea, and sometimes abdominal pain without fever. [cdc.gov]

  The patient returned three days later and reported nausea, vomiting, and weakness. [nejm.org]

  Approximately 5 days after the medical abortion, she developed chills, abdominal pain, nausea, vomiting, and dizziness. Six days after taking mifepristone, due to worsening symptoms, she sought care at her outpatient clinic. [journals.lww.com]

• Refractory Shock

  It produces several exotoxins, which contribute to the progressive edema and refractory shock frequently seen with human infection. [pubmed.ncbi.nlm.nih.gov]

• Spontaneous Rupture of Membranes

  Spontaneous rupture of membranes occurred less than 2 hours after the second dose of misoprostol. Nearly 5 hours after the second dose of misoprostol, the patient complained of feeling warm and experienced shaking chills. [journals.lww.com]

• Arthritis

  Species: C. pasteurianum Binomial name Clostridium sordellii (Hall and Scott, 1927) Prévot, 1938 Clostridium sordellii is a rare anaerobic, gram-positive, spore-forming rod with peritrichous flagella that is capable of causing pneumonia, endocarditis, arthritis [en.wikipedia.org]

  Transmission of C. sordellii infection What CDC is doing Additional Information General Information about C. sordellii Clostridium sordellii [klaw–strĭ–dee–um sore–dell–ee–i] (also called C. sordellii) is a rare bacterium that causes pneumonia, endocarditis, arthritis [cdc.gov]

  Clostridium sordellii has been reported to cause a variety of diseases including peritonitis, endocarditis, pneumonia, arthritis, cellulitis, and myonecrosis [1–4]. [hindawi.com]

  C. sordellii is an infrequent human pathogen but has been reported as a cause of pneumonia, endocarditis, arthritis, peritonitis, and myonecrosis.1,15-17 C. sordellii bacteremia and sepsis occur rarely, primarily among patients with serious underlying [nejm.org]

• Salpingitis

  Abdominal ultrasonography showed evidence of endometritis, salpingitis, and moderate ascites. [journals.lww.com]

• Gram-Positive Rods

  Specifications Specifications ATCC® 9714TM* Product Type Culti-Loops Quality Control Organism Target Organism Class Gram-Positive Rods Format Culti-Loops Description Clostridium sordellii Type Clostridium species Test Type Qualitative QC Packaging [fishersci.se]

  Bottom, Gram stain showing numerous, large gram-positive rods in the necrotic tissues (original magnification, ×400). [academic.oup.com]

  Gram stain of both the uterus and placenta showed large gram-positive rods consistent in morphology with Clostridium species. No postmortem cultures were performed. [journals.lww.com]

• Staphylococcus Aureus

  Immunohistochemical evidence of Clostridium sp, Staphylococcus aureus, and group A Streptococcus in severe soft tissue infections related to injection drug use. Hum Pathol 2006;37:1482–8. Cited Here 18. [journals.lww.com]

  In the non-CTS cases, PCR and/or IHC assays detected C. difficile in 2 cases and Streptococcus pyogenes, Streptococcus agalactiae, Staphylococcus aureus, Neisseria meningitides, Neisseria gonorrhoeae, or Bacillus cereus was identified in one case each [hindawi.com]

  Immunohistochemical assays were performed for clostridium species, Staphylococcus aureus, group A streptococcus, and neisseria species by means of a two-step indirect staining technique with immunoalkaline phosphatase. [nejm.org]

Treatment with antitoxins could, in principle, be clinically useful. [academic.oup.com]

Stevens; Clostridium sordellii Infection: Epidemiology, Clinical Findings, and Current Perspectives on Diagnosis and Treatment; Clinical Infectious Diseases 2006; 43:1436-46 ^ Miech RP. [en.wikipedia.org]

Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis 2006;43:1436–1446.CrossRefGoogle ScholarPubMed 2.Popoff, MR. [cambridge.org]

Early confirmatory diagnosis before the development of irreversible toxic shock is critical for implementation of treatment measures and support of epidemiologic investigations. [hindawi.com]

Treatment with exchange transfusion. Arch Intern Med 1968;122:73–4. Cited Here 8. Li Kim Mui SV, Chitrit Y, Boulanger MC, Maisonneuve L, Choudat L, de Bievre P. [journals.lww.com]

Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis 2006;43:1436–1446.CrossRefGoogle ScholarPubMed 2.Popoff, MR. [cambridge.org]

Stevens; Clostridium sordellii Infection: Epidemiology, Clinical Findings, and Current Perspectives on Diagnosis and Treatment; Clinical Infectious Diseases 2006; 43:1436-46 ^ Miech RP. [en.wikipedia.org]

What CDC is doing CDC experts in microbiology, epidemiology, and perinatology (pregnancy-related complications) are working together with state and local health agencies and the FDA in the investigation of recent deaths associated with C. sordellii. [cdc.gov]

This technology also allows for further multiplexing of additional pathogens associated with toxic shock syndrome that could be of great value for epidemiologic investigations. [hindawi.com]

Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005; 39:1483-8 ^ Nakamura S, Yamakawa K, Nishida S. Antibacterial susceptibility of Clostridium sordellii strains. [en.wikipedia.org]

Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005;39:1483–8. Cited Here 31. Golde S, Ledger WJ. Necrotizing fasciitis in postpartum patients. A report of four cases. [journals.lww.com]

Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005;39:1483-1488 38. Kruse B, Poppema S, Creinin MD, Paul M. Management of side effects and complications in medical abortion. [nejm.org]

Prevention and treatment of gas gangrene, JAMA, 1971, vol. 217 (pg. 806 - 1 ) 12 ., ,. [academic.oup.com]

The Centers for Disease Control and Prevention (CDC) estimates that up to 29% of women who've undergone a medical abortion test positive for C. sordellii in vaginal fluid, compared with only 5% to 10% of women who aren't pregnant.1 (No figures are available [nursingcenter.com]

Older reports suggested that total hysterectomy32 or surgical debridement5 is necessary to remove necrotic tissue and prevent death in cases of C perfringens infection. [journals.lww.com]

Formalin-fixed tissues were evaluated at the Centers for Disease Control and Prevention. [nejm.org]

Disclaimer The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. [hindawi.com]