PROSTHETIC ENDOCARDITIS AND SPLENIC ABSCE SS CAUSED BY CLOSTRIDIUM-CLOSTRIDIFORMIS

We report the first case of Clostridium clostridiformis endocarditis i n a 71 year old man with an aortic prosthetic valve. He was febrile wi th left upper quadrant pain and left lower lobe infiltrate in chest X ray. The diagnosis was made by gram-positive bacilli grown from three blood cultures. Transthoracic and transesophageal echocardiogram showe d a paraaortic abscess. A computed tomographic scan of the abdomen rev ealed a large splenic abscess, He received penicillin G 4 million unit s every 4 hours intravenously. A successful percutaneous drainage guid ed computed tomographic scan was performed, The patient remained febri le and a new computed tomographic scan of the abdomen revealed residua l splenic abscess. A splenectomy was performed. The patient defervesce d on the second day of surgery and remained afebrile during the remain der of his hospitalization. He has returned for medical follow-up and two years later the patient is asymptomatic.