[Clostridium difficile - enterocolitis as a nosocomial problem].
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Clostridium Infections↗
Biomedical subjects
O Sonnabend
Publications and source records attributed to O Sonnabend.
Isolation of Clostridium botulinum type G and identification of type G botulinal toxin in humans: report of five sudden unexpected deaths.
Clostridium botulinum type G has not been identified until now from humans or animals; it has been isolated only twice, from soil samples in Argentina. Type G organisms were isolated from necropsy specimens in four adults and an 18-week-old infant. Type G botulinal toxin was demonstrated in the serum of three of these individuals. The toxic dose in mice ranged from 2 to 7 50% lethal doses/ml. These persons died suddenly and unexpectedly at home, without any pathologic evidence to account for the cause of death in four cases. Symptoms in two individuals were similar to those observed in food-borne botulism. Thus, a prompt postmortem search for toxin and organisms of C. Botulinum in blood and feces may be worthwhile in determining the etiology of unexplained deaths. More microbiologic, physiologic, and toxicologic data are needed to clarify the role of C. botulinum in the pathogenesis of sudden unexpected death in infants and adults.
Adult↗
[Clostridium infections with and without manifest gas gangrene. Report on 77 infections in 76 patients].
Systematic microbiological research and correlation of the histopathological findings obtained from random autopsies revealed 23 hitherto undetected clostridial infections including 11 cases of gas gangrene, 4 of septicemia, 3 of bacteremia, and 5 other clostridial infections. The knowledge gained from this study led to clinical diagnosis of several cases of gas gangrene which were confirmed bacteriologically and histologically. Of 8 hospital patients who were thus diagnosed in this surgical clinic, 7 recovered, including a case of gas gangrene of the abdominal wall. The problem in gas gangrene is timely clinical diagnosis. Little is known about gas edema illnesses which are not traumatically conditioned. Recognition of the local and general symptoms (local, violent, yet inappropriate pain in the wound, "unexplained" postoperative secondary bleeding, appearance of tachycardia wholly unrelated to the patient's temperature, sudden shock, rapid deterioration of patient's general condition, jaundice and rise in CPK) makes it possible to diagnose postoperative gas edema in time. 77 infections with isolation of clostridia, seen in 76 patients, are reported. On the basis of clinical and histopathological criteria they have been classified as follows: 22 cases with gas gangrene (clostridial myonecrosis), 16 cases with anaerobic cellulitis, 20 wound infections, 8 cases of septicemia, 5 of bacteriemia, 1 of tetanus, and 5 other clostridial infections.
Adolescent↗
[A fatal food poisoning caused by bacillus cereus (author's transl)].
The autopsy of a 37 year old man who had died under extraordinary circumstances showed a bromatoxism by bacillus cereus. The verification of the bacillus was possible although the man had already died 2-3 days before; and that in spite of the existence of early beginning rottenness. With the help of morphological findings the pathogenetic effect of the toxins (exotoxin and enterotoxin) of bacillus cereus is discussed. Blood cultures of the heart alone are not sufficient to prove a causal connexion between infection and death. For this purpose bacteriological examination of the organs (liver, spleen, kidney, lungs and brain) is at the same time necessary. An aseptic method, which is described in detail, is the absolute condition for useful results. The forensic value of proof of the bacteriological examination is secured and improved by an additional verification of bacteria in histological specimen coloured by Gram.
Adult↗