Severe Sepsis due toClostridium perfringensBacteremia of Urinary Origin: A Case Report and Systematic Review

Abstract

Clostridium perfringensbacteremia is an uncommon yet serious clinical syndrome that typically arises from a gastrointestinal source. However, clinicians should consider nongastrointestinal sources as well. We present a rare case ofC. perfringensbacteremia of urinary origin that required surgical intervention for definitive treatment. A 61-year-old male presented with acute nausea and vomiting, altered mental status, and chronic diarrhea. His physical exam revealed right costovertebral tenderness and his laboratory work-up revealed acute renal failure. Percutaneous blood cultures grewC. perfringens. Cross-sectional imaging revealed a right-sided ureteral stone with hydronephrosis, which required nephrostomy placement. On placement of the nephrostomy tube, purulent drainage was identified and Gram stain of the drainage revealed Gram-variable rods. A urinary source ofC. perfringenswas clinically supported. Although it is not a common presentation, nongastrointestinal sources such as a urinary source should be considered inC. perfringensbacteremia because failure to recognize a nongastrointestinal source can delay appropriate treatment, which may include surgical intervention.