infectious diseases
Clostridial Intra Abdominal and Pelvic Infections
Introduction
, are common in Mixed Anaerobic Infections resulting from a ruptured viscus or pelvic inflammatory disease. Symptoms of abdominal infection may include fever, pain, and tenderness; symptoms of pelvic infection may include a foul-smelling discharge. Diagnosis is by Gram stain and culture. Treatment is with penicillin and surgical debridement. (See also Overview of Anaerobic Bacteria and Clostridial infections of the abdomen and pelvis are serious and sometimes fatal. Clostridiumspecies are common residents of the gastrointestinal tract and are present in many abdominal infections, generally mixed with other enteric organisms. Clostridia are often the primary agents in the following: Emphysematous cholecystitis Gas gangrene of the uterus (which may occur after delivery and was previously common among patients who had a septic abortion) Certain other female genital tract infections (tubo-ovarian, pelvic, and uterine abscesses) Infection after perforation in colon carcinoma The primary organisms areC. perfringensand, in the case of colon carcinoma,C. septicum. Clostridia produce exotoxins (lecithinases, hemolysins, collagenases, proteases, lipases) that can cause necrosis. Gas formation is common. Clostridial septicemia may cause hemolytic anemia because lecithinase (alpha-toxin) disrupts red blood cell membranes. With severe hemolysis, muscle necrosis, and coexisting toxicity, acute renal failure can occur. 