CENTRAL-NERVOUS-SYSTEM INFECTION DUE TO CLOSTRIDIUM-SEPTICUM - A CASE-REPORT AND REVIEW OF THE LITERATURE

A patient with end stage breast cancer was admitted to hospital due to fever, chills, multiply eroded discharging wounds, and sudden onset o f left hemiparesis. Clostridium septicum bacteremia and brain abscess were diagnosed. The patient was treated successfully ,vith intravenous penicillin and clindamycin and stereotactic aspiration of the abscess . Eleven cases of C, septicum central nervous system infection are rev iewed. They showed an extremely fulminant course and high fatality. Ne vertheless, some relationship seems to exist between outcome and type of brain lesion, Hemolytic-uremic syndrome associated with central ner vous system infection is also discussed, because all these cases in th e literature were due to this organism. Early diagnosis and aggressive treatment, including surgical drainage and appropriate antibiotics, a re the key to improving the prognosis. A long-term prophylactic oral a ntimicrobial agent is suggested for patients who survive this infectio n.