Table 1. Summary of cases with Clostridium septicum infection of Hepatic Metastases
Age
Reference
(yr)/
Primary cancer/
location
Gender
Comorbid conditions
Ischemic heart disease,
Saleh et al
[current
Metastatic
53/M
report]
adenocarcinoma of
colon
cardiomyopathy, s/p
hemicolectomy and
chemotherapy. Liver
metastases treated by
alcohol injection
Clinical presentation
Drainage
procedure
Antibiotics
Outcome
[Follow-up]
Piperacillin-
Fever, cough, hypotension,
high CRP and LFTs. Multiple
Percutaneous
liver abscesses on CT scan.
drainage of
Positive abscess culture,
liver abscess
Negative blood cultures
tazobactam,
followed by
Survived [7
oral
months]
amoxicillinclavulanic acid
Fever, painful,
Kurtz et al
[12]
hepatomegaly and high
Metastatic colon
50/F
cancer including
s/p chemotherapy
liver metastases
CRP. Abdominal CT showed
multiple liver abscesses.
Positive blood and liver
Percutaneous
drainage of
liver abscess
Piperacillintazaobatam
followed by
Died
imipenem
abscess cultures
Fever, nausea, abdominal
Broad
pain, pleuritic chest pain,
Urban et al
[13]
68/M
Metastatic
hypotension, leukocytosis,
adenocarcinoma of
abdominal distension. Liver
colon with liver and
S/P chemotherapy
lung metastases
abscesses with air-fluid
level and
spectrum
Percutaneous
intravenous
drainage of
antibiotics
liver abscess
followed by
suppression
scan. Positive blood cultures
[8]
52/F
days]
oral penicillin
pneumoperitoneum on CT
D’Orsi et al
Survived [37
Metastatic hepatic
S/P hepatic arterial
Fever, chills, hypotension,
Cefalexin,
Adenocarcinoma of
infusion of chemotherapy
Liver abscess on plain
clindamycin
gastrointestinal
for liver metastases
radiographs. Positive blood
primary
complicated by hepatic
cultures.
None
and
gentamicin
Died [6 weeks
after initial
presentation]
artery thrombosis
followed by
oral
chloramphenic
ol
Fever, abdominal pain,
anemia, elevated LFTs and
Adenocarcinoma of
Khan et al [3]
59/M
colon with liver
Hypertension
metastases
renal failure. Liver
abscesses confirmed by CT
and US. Positive blood and
Percutaneous
drainage of
Not specified
Survived [NA]
liver abscess
abscess cultures.
Fever, chills, abdominal
Lee et al [7]
33/F
Choriocarcinoma
S/P dilatation and
with liver
curettage for vaginal
metastases
bleeding
tenderness, leukocytosis,
Cefamezine,
anemia and elevated Alk
Drainage
gentamicin
Survived [2
phos. Liver abscesses on CT
attempted
and
years]
scan and US. Positive blood
metronidazole
cultures.
Fever, tachycardia,
tachypnea, abdominal pain,
Metastatic breast
Thel et al[6]
39/F
cancer (stage IV)
S/P chemotherapy and
including liver
BMT
metastases
blood diarrhea and
Percutaneous
neutropenia. Abdominal CT
drainage of
showed two liver abscesses.
liver abscess
Positive blood cultures.
Ceftazidime
followed by
Survived [2
imipenem and
months]
clindamycin
Negative abscess cultures
Fever, abdominal pain,
Kahn et
al[10]
diarrhea, confusion, pleural
Adenocarcinoma of
44/M
colon with liver
metastases
NA
effusion. Positive blood
cultures. Polymicrobial
infection of liver
metastases.
Surgical
Penicillin G,
drainage of
clindamycin,
abscess
metronidazole
Died of
aspiration
pneumonia 2
months later
Fever, abdominal pain and
Kolbeinsson
et al[9]
Adenocarcinoma of
57/M
colon with liver
tenderness, leukocytosis,
Perforates sigmoid cancer
metastases
hypotension. Positive blood
cultures. Polymicrobial liver
Surgical
drainage
Penicillin G,
Died due to
gentamicin,
relapse of
clindamycin
infection
Not specified
Survived [NA]
abscess cultures.
Sarmiento et
al[14]
Adenocarcinoma of
57/M
Colon with hepatic
metastasis
Perforated transverse
colon cancer
Febrile, septic, abdominal
pain and tenderness.
Positive blood cultures.
Surgical
drainage
Abbreviations
Alk phos, alkaline phosphatase; BMT, bone marrow transplant; CRP, C - reactive protein; CT, computed tomography; F, female; LFTs,
liver function tests; M, male; NA, not available; S/P, status post; US, ultrasound.