Clostridium sordellii Infection: Epidemiology, Clinical Findings, and Current Perspectives on Diagnosis and Treatment

Abstract

Clostridium sordellii infections pose difficult clinical challenges and are usually fatal. Most commonly, these infections occur after trauma, childbirth, and routine gynecological procedures, but they have recently been associated with medically induced abortions and injection drug use. We report 2 fatal cases, one of which was associated with minor trauma, and the other of which was associated with normal childbirth, and we summarize the clinical features of 43 additional cases of reported C. sordellii infection. Of these 45 cases, 8 (18%) were associated with normal childbirth, 5 (11%) were associated with medically induced abortion, and 2 (0.4%) were associated with spontaneous abortion. The case-fatality rate was 100% in these groups. Ten (22%) of the C. sordellii infections occurred in injection drug users, and 50% of these patients died. Other cases of C. sordellii infection (in 19 patients [43%]) occurred after trauma or surgery, mostly in healthy persons, and 53% these patients died. Overall, the mortality rate was 69% (31 of 45 patients). Eighty-five percent of all patients with fatal cases died within 2-6 days of initial infection, and nearly 80% of fatal cases developed leukemoid reactions. Rapid diagnostic tests and improved treatments are needed to reduced the morbidity and mortality associated with this devastating infection.

Distinct kinetics of (H/K/N)Ras glucosylation and Rac1 glucosylation catalysed by Clostridium sordellii lethal toxin

“…Lethal toxin (TcsL) and hemorrhagic toxin (TcsH) are regarded as the major virulence factors of Clostridium sordellii-associated diseases, including enteritis and enterotoxaemia in cattle and sheep and myo-necrosis and gangrene in humans [1,2]. TcsL and TcsH exert their biological activity through mono-glucosylation of Rho and Ras proteins at a pivotal threonine within the effector loop (Thr-37 in RhoA, Thr-35 in Rac/Cdc42 or (H/K/N)Ras) [3,4].…”

Clostridium sordellii Infection of Female Genital Tract: A Rare but Fulminating Reaction

“…Diagnosis is often delayed because there is no rapid diagnostic test for the pathogen. 4 Diagnosis of C. sordellii toxic shock syndrome (TSS) should be suspected when previously healthy women with recent 'clean' obstetric wound present with rapidly spreading edema with cardiovascular decompensation with progressive refractory shock. Definitive diagnosis requires isolation of C. sordellii from infected tissue as blood culture is usually negative.…”

The Ger Receptor Family from Sporulating Bacteria

“…sordellii is an opportunistic pathogen that causes toxic shock syndrome after gynecological procedures (Aldape et al, 2006). In this context, the fact that C. sordellii spores requires bicarbonate and prefer slightly acidic pH for germination is intriguing (Ramirez and Abel-Santos, 2010).…”