Clostridium perfringens

Background

  • Gram positive, rod-shaped obligate anaerobe
  • Food-borne pathogen, associated with previously cooked or poorly reheated meats, poultry, and gravy

Clinical Features

Differential Diagnosis

Acute diarrhea

Infectious

Noninfectious

Watery Diarrhea

  • Enterotoxigenic E. coli (most common cause of watery diarrhea)[1]
  • Norovirus (often has prominent vomiting)
  • Campylobacter
  • Non-typhoidal Salmonella
  • Enteroaggregative E. coli (EAEC)
  • Enterotoxigenic Bacteroides fragilis

Traveler's Diarrhea

Diffuse Abdominal pain

Evaluation

  • If profuse diarrhea or clinical dehydration, check electrolytes, CBC
  • Consider stool studies if:
    • Signs of hypovolemia
    • Fever >38.5
    • Blood or pus in diarrhea
    • Symptoms >2-3 days
    • Elderly, immunocompromised, or recent hospitalization
  • Consider abdominal CT if concern for other critical intrabdominal pathology

Management

  • Self-limited illness, supportive care only

Disposition

  • Majority of patients can be treated as an outpatient
  • Observe or admit patients with severe dehydration and evidence of end-organ complications, significant comorbidities/immunosuppression, or inability to adequately orally rehydrate at home

See Also

External Links

References

Tintinalli's

  1. Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.

Authors:

Claire