December 26, 1966

Clostridium perfringens Septicemia Following Perforation of a Duodenal Ulcer

Author Affiliations

From the Wood Veterans Administration Hospital (Dr. Rose and Dr. Bukosky), and the Marquette University School of Medicine (Dr. Rose), Milwaukee.

JAMA. 1966;198(13):1368-1370. doi:10.1001/jama.1966.03110260080028

CLOSTRIDIUM perfringens (Welch's bacillus), a normal inhabitant of the intestinal tract, and an occasional inhabitant of the biliary tract, may under certain conditions give rise to spontaneous gas gangrene in man. However, reports in the literature concerning cases of clostridial septicemia following spontaneous gas gangrene are exceedingly rare. The first case reported was described by Dayton in 19251; a case in which a perforated gastric ulcer served as the portal of entry for the organism into the blood stream. Since then nine more cases originating from the alimentary tract have been reported in the medical literature, four occurring as complications of cholecystitis,2-5 two as complications of necrotizing enterocolitis,3,6 two as complications of carcinoma of the colon,7,8 and one as a complication of intestinal obstruction.4 Since early clinical and microbiological recognition of spontaneous gas gangrene is all important for attaining successful present-day therapy, we are reporting