CLOSTRIDIUM PERFRINGENS ENTERITIS

 

CLOSTRIDIUM PERFRINGENS ENTERITIS

 

DEFINITION:

A bacterial infection of the small intestine caused by C. perfringens resulting in a secretory diarrhea.

EPIDEMIOLOGY:

  • incidence: 1% of causes of diarrhea
  • risk factors:
    • age: all ages
    • season: all seasons
    • route: indirect: common cause of food poisoning
    • environ: epidemics
  • incubation period: 7-15 hours

PATHOGENESIS:

1. Background

  • Clostridium perfringens is a gram negative rod
    • type A causes a mild and common form of food poisoning
    • produce an enterotoxin:
      • MW: 35,000 daltons
      • resistent to trypsin digestion
      • binds to a brush border membrane receptor -> disrupts cell integrity -> cell death

2. C. Perfringens Food Poisoning

  • "food poisoning follows the ingestion of contaiminated cooked meats, poultry, stew, meat pies and gravies that have undergone long periods of slow cooling and ambient temperature storage which facilitates spore survival"
  • contaminated foods contain at least 10 million organisms which during intestinal passage proliferate and produce toxin

CLINICAL FEATURES:

1. Gastrointestinal Manifestatons

  • diarrhea (90%)
  • abdominal cramps (80%)
  • nausea/vomiting (15-25%)
  • fever (25%)
    • all resolve spontaneously in 6-24 hours

INVESTIGATIONS:

1. Stools

  • culture - a million organisms/g of stool within 48 hrs of onset

2. Serum

  • serology - detection of enterotoxin by ELISA

MANAGEMENT:

1. Supportive

  • oral rehydration fluid (ORF) or IV rehydration

2. Medications

  • none indicated

 

 

Pediatric Database - CLOSTRIDIUM PERFRINGENS ENTERITIS

Pediatric Organization - Pedbase [at] Gmail.com