Clostridium tertiumSepticemia

Postoperative Clostridium tertium septicemia in a non-neutropenic pediatric patient

“…tertium is different from other Clostridium species because it can be cultured under aerobic conditions. [4] Because of the fact that C. tertium is observed as both gram-positive and -negative bacilli, it can be misidentified as Corynebacterium or Bacillus species; thus, it usually takes considerable time to identify the species using classical bacteriological techniques. [2][3][4][5][6][7][8][9][10] Hence, in our case, we initially misidentified C. tertium as L. grayi.…”

“…To date, although most documented cases have involved neutropenic patients, [2,[5][6][7][9][10][11] cases involving non-neutropenic patients have also been described. [2,4,7,8] Salvador et al [11] reported that C. tertium could be rapidly identified using a novel mass spectrometry technology (matrix assisted laser desorption ionization timeof-flight). In this case, we believe that C. tertium was the cause of septicemia because the organism was independently cultured and that the bacterium identified in the anal wound cultures was different.…”

“…[3] However, the pathogenicity of this organism was unrecognized until the first report of C. tertium bacteremia in 1963. [4] Although C. tertium has been isolated from blood in most reported cases of C. tertium infection, it has also been implicated in spontaneous bacterial peritonitis, brain abscesses, nasopharyngeal carcinoma, and pneumonia. [2,[4][5][6][7][8][9][10] However, the pathogenicity of this organism remains unclear.…”

“…[4] Although C. tertium has been isolated from blood in most reported cases of C. tertium infection, it has also been implicated in spontaneous bacterial peritonitis, brain abscesses, nasopharyngeal carcinoma, and pneumonia. [2,[4][5][6][7][8][9][10] However, the pathogenicity of this organism remains unclear. [10] C. tertium can easily be misidentified because of its non-toxinproducing, aerotolerant, and gram-variable properties, which are different to those of other clostridia.…”

“…Almost all the reported cases of C. tertium bacteremia have occurred in neutropenic patients without any obvious source of infection. [2, 5-7, 9, 10] In contrast, bacteremia in non-neutropenic patients is rare, [2,4,7,8] and Table 1 summarizes all the known cases. A fatal case involving a non-neutropenic patient has been documented; [8] hence, a rapid diagnosis is desirable.…”