Uterine Clostridium perfringens infection related to gynecologic malignancy
Uterine gas gangrene caused by Clostridium perfringens is a serious, often life-threatening infection that is rarely encountered in the practice of gynecologic oncology. However, the hypoxic nature of gynecologic cancers due to necrosis and/or prior radiation therapy creates a microenvironment optim...
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doaj-800b4ddd2e9e4353ab30ff853eb6db7e2020-11-24T22:59:39ZengElsevierGynecologic Oncology Reports2352-57892017-11-0122C555710.1016/j.gore.2017.09.006Uterine Clostridium perfringens infection related to gynecologic malignancyKevin M. Kremer0Megan E. McDonald1Michael J. Goodheart2Department of Obstetrics and Gynecology, University of Missouri, Columbia, MO 65202, United StatesDepartment of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, United StatesDepartment of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, United StatesUterine gas gangrene caused by Clostridium perfringens is a serious, often life-threatening infection that is rarely encountered in the practice of gynecologic oncology. However, the hypoxic nature of gynecologic cancers due to necrosis and/or prior radiation therapy creates a microenvironment optimal for proliferation of anaerobic bacteria such as the Clostridium species. Early recognition and aggressive treatment with IV antibiotics and surgical debridement remain the cornerstones of management in order to decrease morbidity and mortality. Here we present the case of a 52 year-old woman with a remote history of cervical cancer who was previously treated at our institution with primary chemotherapy and radiation and was then admitted decades later with Clostridium perfringens bacteremia and CT evidence of intrauterine abscess. The patient received a prolonged course of IV antibiotic therapy and subsequently underwent definitive surgical management with a total abdominal hysterectomy, bilateral salpingo-oophorectomy, small bowel resection with anastomosis for a utero-ileal fistula identified intraoperatively. Pathology from the uterine specimen demonstrated a primary poorly differentiated uterine adenocarcinoma. The patient recovered fully from her Clostridium perfringens infection and was discharged from the hospital shortly after surgical intervention.http://www.sciencedirect.com/science/article/pii/S2352578917300978Clostridium perfringensGynecologic malignancyPelvic radiationEndometrial cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kevin M. Kremer Megan E. McDonald Michael J. Goodheart |
spellingShingle |
Kevin M. Kremer Megan E. McDonald Michael J. Goodheart Uterine Clostridium perfringens infection related to gynecologic malignancy Gynecologic Oncology Reports Clostridium perfringens Gynecologic malignancy Pelvic radiation Endometrial cancer |
author_facet |
Kevin M. Kremer Megan E. McDonald Michael J. Goodheart |
author_sort |
Kevin M. Kremer |
title |
Uterine Clostridium perfringens infection related to gynecologic malignancy |
title_short |
Uterine Clostridium perfringens infection related to gynecologic malignancy |
title_full |
Uterine Clostridium perfringens infection related to gynecologic malignancy |
title_fullStr |
Uterine Clostridium perfringens infection related to gynecologic malignancy |
title_full_unstemmed |
Uterine Clostridium perfringens infection related to gynecologic malignancy |
title_sort |
uterine clostridium perfringens infection related to gynecologic malignancy |
publisher |
Elsevier |
series |
Gynecologic Oncology Reports |
issn |
2352-5789 |
publishDate |
2017-11-01 |
description |
Uterine gas gangrene caused by Clostridium perfringens is a serious, often life-threatening infection that is rarely encountered in the practice of gynecologic oncology. However, the hypoxic nature of gynecologic cancers due to necrosis and/or prior radiation therapy creates a microenvironment optimal for proliferation of anaerobic bacteria such as the Clostridium species. Early recognition and aggressive treatment with IV antibiotics and surgical debridement remain the cornerstones of management in order to decrease morbidity and mortality. Here we present the case of a 52 year-old woman with a remote history of cervical cancer who was previously treated at our institution with primary chemotherapy and radiation and was then admitted decades later with Clostridium perfringens bacteremia and CT evidence of intrauterine abscess. The patient received a prolonged course of IV antibiotic therapy and subsequently underwent definitive surgical management with a total abdominal hysterectomy, bilateral salpingo-oophorectomy, small bowel resection with anastomosis for a utero-ileal fistula identified intraoperatively. Pathology from the uterine specimen demonstrated a primary poorly differentiated uterine adenocarcinoma. The patient recovered fully from her Clostridium perfringens infection and was discharged from the hospital shortly after surgical intervention. |
topic |
Clostridium perfringens Gynecologic malignancy Pelvic radiation Endometrial cancer |
url |
http://www.sciencedirect.com/science/article/pii/S2352578917300978 |
work_keys_str_mv |
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