Title : Rare case of clostridium cadaveris in an immunocompromised patient with metastatic rectal adenocarcinoma
Abstract:
Case of a 50 y/o patient with metastatic rectal adenocarcinoma on 5th line chemotherapy who presented with fever and anemia. Was found to have blood cultures positive for Clostridium cadaveris that remained positive for 10 days despite broad spectrum antibiotics. The case discusses the incidence, rarity and varied etiology and management of the infection. Clostridium cadaveris is rarely responsible for causing clinical pathology. Only 8 cases have been documented till date causing bacteremia from GI source, osteomyelitis or bacterial peritonitis. Usual underlying risk factors include immunosuppression, decubitus ulcer, cardiovascular disorders, diabetes mellitus, bowel necrosis etc. Significant mortality is associated with the infection. It is not clear if the infection itself is robust enough to cause the mortality or is it the underlying limited and poor prognosis due to immunosuppression that is responsible for causing the detrimental outcome.
In terms of management, no proposed regimen is available.
The case is unique in terms of its rare incidence. This presentation will be an opportunity to bring to light the details of such a case and reflect in brief regarding the finesse of management of such an infection in an already immunocompromised patient and the need to have a broad differential.
Audience Take Away:
- Understand the clinical presentation and epidemiology of the disease
- A preliminary diagnostic bundle for the infection, other contributing risk factors
- The importance of anaerobic blood cultures in susceptible cases and importance of close monitoring in an immunocompromised patient that can help other physicians in a similar situation
- Lastly, getting into the depth of possible first line management of the infection and choices of antibiotics given there is no regimen available till date
