Received Dec 16; Accepted May 9. For commercial re-use, please contact journals. This article has been cited by other articles in PMC. Abstract Clostridium bifermentans is a rare pathogen in humans. A fatal case of fulminant endometritis with toxic shock and capillary leak secondary to C bifermentans infection in a young woman is described, and this is compared to all 13 previously described cases of C bifermentans infection.
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Telephone , fax , e-mail ac. For commercial reuse, contact moc. Abstract A case of pneumonia with associated empyema caused by Clostridium bifermentans is described. C bifermentans is an anaerobic, spore-forming, Gram-positive bacillus. This organism is infrequently reported as a cause of infection in humans, and older publications tended to regard it as nonpathogenic. However, in more recent reports, C bifermentans has been documented as a cause of septic arthritis, osteomyelitis, soft tissue infection, abdominal infections, brain abscess, bacteremia and endocarditis.
The present case is the third reported case of empyema caused by C bifermentans, and it serves to further define the spectrum of illness due to this uncommon organism.
The patient also complained of sharp right-sided pleuritic chest pain, as well as right upper quadrant abdominal pain associated with deep breathing. He denied nausea and vomiting. A review of systems was otherwise negative. The patient was a heavy smoker and reported occasional alcohol consumption. He denied the use of intravenous recreational drugs. On physical examination at the time of presentation, the patient was noted to be febrile, with an oral temperature of He was otherwise hemodynamically stable.
The patient was edentulous. On respiratory examination, decreased air entry was noted in the right lower and middle lobes. Bronchial breath sounds were noted at the right lung base, and crepitations were heard with auscultation over the rest of the right lung. The abdomen was tender to palpation in the right upper quadrant.
The remainder of the physical examination was unremarkable. Laboratory investigations performed on presentation demonstrated an elevated total leukocyte count Blood cultures aerobic and anaerobic were negative. On chest radiography, a right-sided pneumothorax with right lower lobe consolidation and associated pleural fluid was apparent Figure 1. The patient underwent a noncontrast computed tomography CT scan of the abdomen to rule out a subdiaphragmatic abscess in view of the right upper quadrant abdominal pain.
No intra-abdominal abnormality was noted; however, the assessment did confirm a right-sided hydropneumothorax, with areas of pulmonary consolidation and loculated pleural fluid.
Overview[ edit ] Clostridium contains around species that include common free-living bacteria, as well as important pathogens. This same toxin is known as Botox and is used in cosmetic surgery to paralyze facial muscles to reduce the signs of aging; it also has numerous other therapeutic uses. Clostridium tetani causes tetanus. Clostridium sordellii can cause a fatal infection in exceptionally rare cases after medical abortions. Microbiologists distinguish Clostridium from Bacillus by the following features:  Clostridium grows in anaerobic conditions; Bacillus grows in aerobic conditions. Clostridium forms bottle-shaped endospores; Bacillus forms oblong endospores. Clostridium does not form the enzyme catalase ; Bacillus secretes catalase to destroy toxic byproducts of oxygen metabolism.
Toxins and mosquito larvae[ edit ] A certain subspecies , Clostridium bifermentans subsp. Malaysia, was the first anaerobic bacterium known to kill mosquito larvae. The subspecies was part of a collection at the Institute for Medical Research, Malaysia. A biochemical analysis found that the mosquitocidal cry toxin is coded by four genes in an operon : cry16Aa, cry17Aa, cbm When the four genes were individually expressed, none of the four proteins encoded exhibited mosquitocidal activity. This suggests that the toxicity requires four proteins cooperating as a complex to take effect.