For health professionals: Clostridium perfringens infection

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What health professionals need to know about Clostridium perfringens infection

Clostridium perfringens is a common cause of food poisoning in Canada. Deaths due to the disease are rare. Deaths occur mainly in:

  • the elderly
  • those who are debilitated
  • individuals predisposed to the disease

High risk foods include:

  • stews
  • gravies
  • meat pies
  • thick soups
  • cooked beans
  • dried or precooked foods
  • raw meat, especially poultry and beef

Clostridium perfringens is the most common cause of trauma-associated gas gangrene, which has a very high mortality rate.

It is not directly transmitted from person to person.

Clinical manifestations

Clostridium perfringens has several clinical manifestations, including clostridial food poisoning.

Clostridial food poisoning

Food poisoning can be caused by Clostridium perfringens enterotoxin (CPE), produced by bacterial spores in the small intestine. Main symptoms of the disease are:

  • abdominal pain
  • explosive diarrhea (cardinal sign)
  • fever, nausea and vomiting (rare)

The disease is usually mild and self-limiting in healthy individuals, with symptoms resolving within 24 hours.

Clostridial Soft Tissues Infections
(Clostridial myonecrosis, gas gangrene)

Toxins produced by Clostridium perfringens are the most common cause of clostridial myonecrosis, or gas gangrene. Symptoms usually develop hours or days after an extremity is injured by severe crushing or penetrating trauma that devitalizes tissue, creating anaerobic conditions.

It is manifested by:

  • pallor
  • edema
  • tenderness
  • severe pain

These additional symptoms follow:

  • discolouration
  • hemorrhagic bullae
  • production of gas at the site of wound

 

Systemic manifestations of the disease include:

  • shock
  • bacteremia
  • renal failure
  • hypotension
  • intravascular hemolysis leading to coma and death

Clostridial cellulitis

Clostridium perfringens is the most common cause of clostridial cellulitis. Clostridial cellulitis is often associated with local trauma or recent surgery. Infection is less systemic than in clostridial myonecrosis. It is a localized infection with associated skin and soft tissue necrosis, but sparing of the fascia and deep muscles.

Surveillance

Health professionals in Canada play a critical role in identifying and reporting cases of Clostridium perfringens. See the surveillance section on Clostridium perfringens for more information on surveillance in Canada.

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