CLINICAL COURSES OF 7 SURVIVORS OF CLOSTRIDIUM-SEPTICUM INFECTION ANDTHEIR IMMUNOLOGICAL RESPONSES TO ALPHA-TOXIN

Clostridium septicum bacteremia typically portends a fulminant disease associated with high mortality. We describe the clinical courses of s even survivors of C. septicum infection and their antibody responses t o the alpha toxin produced by C. septicum. Three patients had clinical syndromes ranging from uncomplicated bacteremia to early typhlitis, a nd three patients had syndromes ranging from abscess to myonecrosis an d septic shock. In addition, an AIDS patient who developed septic shoc k and who had extensive gas in the retroperitoneal musculature did not undergo surgery but survived after receiving antimicrobial therapy an d intensive supportive care. Both immunocompetent patients with myonec rosis had detectable IgG to alpha toxin by immunoblot analysis. IgG to alpha toxin was not detected in the four immunocompetent patients who had C. septicum bacteremia but who did not have myonecrosis or in the AIDS patient with myonecrosis. Therefore, humoral responses to alpha toxin during C. septicum infection may be related to the host's clinic al syndrome and immune status.