Surgical aspects of Clostridium septicum septicemia.

Clostridium septicum is a virulent cause of gas gangrene and sepsis. Although thought to be rare, a survey of our affiliated hospitals for a recent five-year period disclosed eight cases. Seven of the eight had an occult malignant neoplasm. The eighth patient was thought to be preleukemic. All seven malignant neoplasms involved the gastrointestinal tract. Four patients were admitted with gangrene of an extremity, three with abdominal pain, and one with both. In four patients, C septicum septicemia appeared in an extremity before the underlying gastrointestinal malignant neoplasm was recognized. Four patients had surgical therapy and two survived; four received medical therapy and one survived. Patients who have C septicum septicemia should be assumed to harbor an underlying malignant neoplasm until proved otherwise.