Causes of Clostridium septicum bacteremia:
(1) colon carcinoma, often right-sided
(2) other disruption of the ileal and/or colonic mucosa (perforation, mucosal ulceration, etc.)
(3) acute leukemia
(4) neutropenia (associated with neutropenic enterocolitis)
(5) myonecrosis
Factors associated with a poor prognosis for the patient:
(1) septic shock
(2) cirrhosis
(3) delay in antibiotic therapy
(4) immunosuppression
Management of the patient:
(1) Prompt antibiotic therapy and resuscitation if required.
(2) Identification of source (CBC with blood smear review, physical examination for signs of infection, colonoscopy).
(3) Appropriate management of neutropenic enterocolitis if present, which may include surgical resection.
(4) Examination for occult sites of disseminated infection (heart, eye, brain, orthopedic, other).
