Lethal human neutropenic entercolitis caused by Clostridium chauvoei in the United States: Tip of the iceberg?

摘要: The patient is a 44-year-old woman with metastatic grade 3 intra-ductal carcinoma of the breast who was started on palliative chemotherapy (docetaxel) 10 days prior to admission and presented emergency center complaining diffuse abdominal pain generalized weakness. CT abdomen showed bowel wall thickening from cecum transverse colon free fluid in pelvis. neutropenic (absolute neutrophil count 600 cells/μl). She received antibiotics for 21 enterocolitis. Blood culture isolate sent 16s rRNA gene sequencing, which identified Clostridium chauvoei. While C. chauvoei has long history veterinary importance, this first documented case infection caused by human United States. close phylogenetic relationship septicum making two species difficult differentiate using conventional microbiologic methods. With increased use more reliable detection methods actual prevalence causing disease may be higher than currently recognized.