Enteritis Necroticans (Pigbel) in a Diabetic Child

Tm, Petrillo; Cm, Beck-Sagué; Jg, Songer; Abramowsky, Carlos R.; Jd, Fortenberry; Meacham, Lillian R.; Ag, Dean; H, Lee; Dm, Bueschel; Nesheim,

doi:10.1056/nejm200004273421704

Cited by 112 publications

(63 citation statements)

References 23 publications

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“…Since 1984, two cases of C. perfringens, Type C enteritis necroticans have been reported in the United States, two in England, and one in Australia (Table 1: [11][12][13][14][15]. Three of these five patients had Type 1 or Type 2 diabetes mellitus (11)(12)(13)15).…”

Section: Discussionmentioning

confidence: 99%

“…Three of these five patients had Type 1 or Type 2 diabetes mellitus (11)(12)(13)15). One of the nondiabetics was a vegetarian who consumed large amounts of sweet potatoes, soybeans, and peanut sauce, all of which contain trypsin inhibitors that were thought to have predisposed the patient to the disease (14).…”

Section: Discussionmentioning

confidence: 99%

“…The genes for the ␣ and ␤ toxins of C. perfringens, Type C, are designated cpa and cpb, respectively. The PCR amplification of cpa and cpb products with gene specific primers allows the identification of C. perfringens, Type C, and its discrimination from Type A (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, a case of enteritis necroticans was recently reported in a 12-year-old boy in Georgia with poorly controlled diabetes who ate pig intestines (chitterlings). The patient recovered completely after resection of the necrotic segment of bowel (15). We report a fatal case in the southeastern United States of enteritis necroticans caused by C. perfringens, Type C, in an adult with Type 2 diabetes mellitus.…”

mentioning

confidence: 98%

“…Only a few cases have been identified in developed countries (11)(12)(13)(14)(15). In the United States, a case of enteritis necroticans was recently reported in a 12-year-old boy in Georgia with poorly controlled diabetes who ate pig intestines (chitterlings).…”

mentioning

confidence: 99%

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Fatal Enteritis Necroticans (Pigbel) in a Diabetic Adult

et al. 2002

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Enteritis necroticans is a segmental necrotizing infection of the jejunum and ileum caused by Clostridium perfringens, Type C. The disease occurs sporadically in parts of Asia, Africa, and the South Pacific, where it primarily affects children with severe protein malnutrition. The disease is extremely rare in developed countries, where it has been seen primarily in diabetics. Two cases have previously been reported in the United States, one in a child with poorly controlled Type 1 diabetes. A 66-yearold woman with a 12-year history of Type 2 diabetes mellitus developed severe abdominal pain and bloody diarrhea after eating a meal of turkey sausage. She died unattended at home. An autopsy showed peritonitis and segmental necrosis of the jejunum and ileum. Microscopic examination showed Gram-positive club-shaped bacilli consistent with Clostridia coating a necrotic mucosa. Products of cpa and cpb genes of C. perfringens, Type C were identified in the necrotic jejunum by polymerase chain reaction amplification.

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