Small bowel (small intestine)
Infectious disorders
Clostridium

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 14 February 2018, last major update August 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Clostridium[TI] small bowel[TIAB]

Cite this page: Gulwani, H. Clostridium. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/smallbowelclostridium.html. Accessed April 21st, 2018.
Definition / general
Clostridium difficile:
  • Causes bloody diarrhea after antibiotics (antibiotic associated colitis)
  • Other risk factors include inflammatory bowel disease, colectomy with ileostomy or other bowel surgery (Anaerobe 2011;17:52)
  • Due to cytotoxin but locally invasive only
  • Nosocomial spread

Clostridium perfringens:
  • Causes watery diarrhea
  • Produces enterotoxin and usually noninvasive
  • Transmitted from meat, poultry, fish

Clostridium perfringens, type C strain:
  • Produces severe necrotizing enterocolitis of jejunum and ileum (enteritis necroticans) with perforation, also called pigbel, a pidgin English term for abdominal pain after a pig feast, reflecting a 1963 cluster of cases
  • Occurred after World War II in previously starved children / adults after eating large meals of meat and vegetables
  • Currently associated with severe protein malnutrition in Asia, Africa, South Pacific
  • Rarely occurs in developed countries in patients with diabetes
  • High mortality rate unless diagnose early and treat with antibiotics or surgical excision of necrotic bowel
  • Preventative vaccine is available for toxin
Case reports
  • 66 year old woman with type 2 diabetes mellitus who developed severe abdominal pain and bloody diarrhea from cooked turkey sausage (Mod Pathol 2002;15:66)
Gross description
  • Segmental necrosis of proximal jejunum
Microscopic (histologic) description
  • Ischemic changes with necrotic villi, inflammatory cells and fibrinoid necrosis of vessel
Microscopic (histologic) images

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Crypt eruption and pseudomembranes