infectious diseases
Clostridial Intra Abdominal and Pelvic Infections
Symptoms and Signs
Symptoms of clostridial infections are similar to those of other abdominal infections (eg, pain, fever, abdominal tenderness, a toxic appearance). Patients with a uterine infection may have a foul-smelling, bloody vaginal discharge, and gas sometimes escapes through the cervix. Rarely, acute tubular necrosis develops. Sepsis may be a complication of intra-abdominal or uterine clostridial infections. Initial symptoms can include fever, chills, vomiting, diarrhea, abdominal pain, hypotension, tachycardia, jaundice, cyanosis, and oliguria. In 7 to 15% of patients with sepsis due toC. perfringens, acute massive intravascular hemolysis occurs. These patients have jaundice and red-tinged serum and urine. Spherocytes, ghost cells, and sometimesC. perfringenscan be seen in a stained blood smear. Blood cultures are positive forC. perfringens. Clostridial sepsis may result in multiorgan failure, which is frequently fatal, often within 24 hours of hospital admission. 