Clinical Snapshot
Clostridium perfringens Lung Abscess
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A female patient in her 20s developed fatigue, fever, and cough. X-ray (panel A) and computed tomography of the chest (panel B) showed consolidation with an air–fluid level in the right lower lobe. Clostridium perfringens was detected in one anaerobic blood culture from a total of two paired blood cultures. HIV testing was negative, and there was no evidence of diabetes mellitus or immunosuppression. Possible sources of infection included microaspirations following bariatric surgery 2 years previously or the following interventions in the preceding 6 months: lip injections, esophagogastroduodenoscopy and colonoscopy with biopsies, and root canal treatment. The patient received penicillin G (5 million IU, 6 × daily) and clindamycin (900 mg 3 × daily) for 9 days. Clindamycin inhibits toxin production by Clostridium perfringens, which, however, is typically low in lung abscesses. Owing to the patient’s good response and the absence of signs of systemic Clostridium toxicity, she was switched to amoxicillin (1000 mg, 3 × daily) for 6 weeks. Computed tomography 2 months following the start of treatment showed significant residual parenchymal damage with complete resolution of the abscess. The patient was asymptomatic.
Danksagung: Wir danken Herrn Giertzsch und Dr. med. Sieben von der Klinik und Poliklinik für diagnostische und interventionelle Radiologie am Universitätsklinikum Hamburg-Eppendorf für die Bereitstellung der angefertigten Bilder.
Paul Griebel, Dr. med. Stefan Schmiedel, 1. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, pgriebel.bwh@gmail.com
Conflict of interest statement: The authors state that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Griebel P, Schmiedel S: Clostridium perfringens lung abscess. Dtsch Arztebl Int 2025; 122: 728. DOI: 10.3238/arztebl.m2025.0124
