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World J Gastroenterol. Oct 21, 2012; 18(39): 5632-5634
Published online Oct 21, 2012. doi: 10.3748/wjg.v18.i39.5632
Published online Oct 21, 2012. doi: 10.3748/wjg.v18.i39.5632
Clostridium perfringens bacteremia caused by choledocholithiasis in the absence of gallbladder stones
Antwan Atia, Robert Patton, Mark Young, Departments of Gastroenterology, James H Quillen VA Medical Center, Johnson, Mountain Home, TN 37615, United States
Tejas Raiyani, Pranav Patel, General Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson, Mountain Home, TN 37615, United States
Author contributions: Atia A managed patient while being hospitalized and he wrote the discussion section; Raiyani T and Patel P wrote the abstract, introduction and case part; Patton R managed the case and did revision of the manuscript; and Young M did final critical revision of the papers.
Correspondence to: Antwan Atia, MD, Departments of Gastroenterology, James H Quillen VA Medical Center, Johnson, Mountain Home, TN 37615, United States. antwan.atia@yahoo.com
Telephone: +1-423-7477774 Fax: +1-423-7477774
Received: August 30, 2011
Revised: April 20, 2012
Accepted: April 22, 2012
Published online: October 21, 2012
Revised: April 20, 2012
Accepted: April 22, 2012
Published online: October 21, 2012
Abstract
A 67-years-old male presented with periumbilical abdominal pain, fever and jaundice. His anaerobic blood culture was positive for clostridium perfringens. Computed tomogram scan of the abdomen and abdominal ultrasound showed normal gallbladder and common bile duct (CBD). Subsequently magnetic resonance cholangiopancreaticogram showed choledocholithiasis. Endoscopic retrograde cholangiopancreaticogramwith sphincterotomy and CBD stone extraction was performed. The patient progressively improved with antibiotic therapy Choledocholithiasis should be considered as a source of clostridium perfringens bacteremia especially in the setting of elevated liver enzymes with cholestatic pattern.
Keywords: Choledocholithiasis, Clostridium perfringens, Bacteremia