CLOSTRIDIUM BIFERMENTANS PDF

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.

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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.

Keywords: capillary leak, Clostridium bifermentans, Clostridium sordellii, hyperleukocytosis, toxic shock syndrome In October , a year-old woman with history of abnormal uterine bleeding status post an uncomplicated endometrial ablation 5 months prior developed new onset dysuria and grayish, malodorous vaginal discharge.

She was prescribed levofloxacin but never filled it. Three days later, she was hospitalized after multiple syncopal events at home. She was afebrile, without rash, and extremities were cool. Abdominal exam was notable for obesity but was otherwise benign.

Pelvic examination showed no cervical motion tenderness, cervical discharge, or other abnormality. Computed tomography CT scan of the abdomen and pelvis showed ascites, and a pelvic ultrasound was unremarkable. Empiric antibiotic therapy with vancomycin, cefepime, and metronidazole was initiated, and she was transferred to the intensive care unit.

Lactate increased to Tobramycin, clindamycin, and doxycycline were added for sepsis. Despite vasopressor support, she required massive IV fluid resuscitation to maintain pressures and perfusion, receiving 26 liters during the first 24 hours and 51 liters by 72 hours.

In addition, she showed signs of disseminated intravascular coagulation DIC and received 46 units of blood product fresh frozen plasma, platelets, and cryoprecipitate over 72 hours. Transthoracic echocardiogram showed a large pericardial effusion with cardiac tamponade, which required pericardial drain placement with removal of mL transudative fluid.

She also developed large bilateral pleural effusions and required bilateral chest tube placement with 4 liters per day transudative fluid output. Given the profound intra-abdominal fluid, there was concern for potential abdominal catastrophe; thus, she had an exploratory laparotomy, which was negative for any signs of intra-abdominal infection or viscous perforation, although there was massive ascites. The uterus was hyperemic but not grossly infected or boggy. Vaginal swabs did not isolate Staphylococcus aureus or yeast; cervical swabs were negative for gonorrhea and chlamydia by nucleic acid amplification testing.

Blood smear showed marked neutrophilia and no evidence of hematologic malignancy. Bone marrow biopsy was negative for malignancy. Human immunodeficiency virus-1 antibody was negative.

Blood, urine, pleural fluid, pericardial fluid, peritoneal fluid, and sputum cultures were negative for microorganisms. She developed profound anasarca, and a repeat pelvic or ophthalmologic exam was unable to be performed because of massive edema.

Her clinical picture was felt to be consistent with a toxin-mediated process, potentially related to Clostridium sordellii given how this pathogen typically presents.

Thus, to remove potential toxin, empiric plasmapheresis was started on hospital day 3, which showed immediate improvement in hemodynamics, and fluid was able to be removed with continuous venovenous hemofiltration.

On hospital day 4, her edema had improved and the team was able to examine her pupils, which were found to be fixed and dilated. A CT head scan showed diffuse cerebral edema and tonsillar herniation. A family meeting was convened, life support was withdrawn, and she died shortly thereafter. An autopsy demonstrated diffuse edema and evidence of DIC in all organs.

Diffuse endometrial necrosis was noted on histopathological examination of the uterus. Special stains demonstrated large, boxcar-shaped, Gram-positive rods within endometrial tissue. Although polymerase chain reaction PCR assay specific for C sordellii was negative, wide-range 16 S PCR assay of endometrial tissue was positive for Clostridium bifermentans. Postmortem endometrial cultures were negative.

COLOSTOMIA TIPO HARTMAN PDF

Clostridium bifermentans

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. Keywords: capillary leak, Clostridium bifermentans, Clostridium sordellii, hyperleukocytosis, toxic shock syndrome In October , a year-old woman with history of abnormal uterine bleeding status post an uncomplicated endometrial ablation 5 months prior developed new onset dysuria and grayish, malodorous vaginal discharge. She was prescribed levofloxacin but never filled it.

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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.

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