A 62-year-old man with iron deficiency anaemia and occult blood in stool develops fever and blood cultures grow an anaerobic Gram-positive rod. The microbiologist alerts the clinician because bacteraemia with this particular organism is classically associated with:
- A Clostridium tetani, indicating a missed contaminated wound
- B Clostridium botulinum, suggesting ingestion of home-canned food
- C Clostridium septicum, suggesting an underlying colonic malignancy ✓
- D Clostridium sordellii, suggesting recent gynaecological surgery
Correct answer: C. Clostridium septicum, suggesting an underlying colonic malignancy
Explanation
Clostridium septicum bacteraemia is strongly associated with colorectal carcinoma and with haematological malignancy accompanied by neutropenia, because the organism seeds the bloodstream through a breached or necrotic bowel wall. Its detection should prompt evaluation of the colon. Tetani and botulinum are essentially never blood culture isolates, and sordellii is linked to trauma, childbirth and injection drug use rather than malignancy.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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