C. septicum and Malignancy — SCE Infectious Diseases MCQ

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ModerateHealthcare-Associated InfectionsC. septicum and MalignancySCE Infectious Diseases

A 55-year-old man develops Clostridium septicum bacteraemia. He has no history of trauma or surgery. What underlying condition should be urgently investigated?

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Correct answer: A — Occult colorectal malignancy — C. septicum bacteraemia has a strong association with GI malignancy

D. septicum bacteraemia without an obvious portal of entry has a well-established association with occult malignancy, particularly colorectal carcinoma and haematological malignancies (especially neutropenic patients with leukaemia/lymphoma). The proposed mechanism is translocation of C. septicum spores through a disrupted GI mucosal barrier (from tumour or chemotherapy-induced mucositis). Colonoscopy should be performed once the acute infection is controlled. C. septicum can also cause gas gangrene (atraumatic, non-clostridial myonecrosis).

Reference: BSAC 2023 – Clostridial infections; BMJ 2020 – C. septicum and malignancy