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Rare postoperative complication: Clostridium perfringens septic shock following elective abdominal surgery.

BMJ Case Reports 2017 October 10
Postoperative infections are one of the most common complications in general surgery, and while rates have reduced with the routine administration of perioperative antibiotics, around 5% of patients undergoing a surgical procedure will develop an infective complication.1 The Gram-positive, obligate anaerobe, Clostridium perfringens , is a well-known pathogen that forms part of both the environmental and gastrointestinal flora.2 While more commonly associated with food poisoning, anaerobic cellulitis and traumatic gas gangrene, rare cases of spontaneous non-traumatic gas gangrene of abdominal viscera have also been recorded.3 Although potentially treatable with appropriate antibiotic cover, cases of C. perfringens can rapidly progress into fulminant and fatal sepsis.4 Moreover, the timing of symptom onset postoperatively can vary significantly, reports ranging from hours to days.5 6 We report a case of C. perfringens- induced septic shock following elective bowel resection.

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