Fatal Enteritis Necroticans (Pigbel) in a Diabetic Adult

Enteritis necroticans is a segmental necrotizing infection of the jejunum and ileum caused by Clostridium perfringens, Type C. The disease occurs sporadically in parts of Asia, Africa, and the South Pacific, where it primarily affects children with severe protein malnutrition. The disease is extreme...

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Bibliographic Details
Published in:Modern pathology 2002-01, Vol.15 (1), p.66-70
Main Authors: Gui, Lizhen, Subramony, Charu, Fratkin, Jonathan, Hughson, Michael D
Format: Article
Language:English
Subjects:
Aged
case-report
Clostridium Infections - complications
Clostridium Infections - pathology
Clostridium perfringens
Clostridium perfringens - genetics
Clostridium perfringens - isolation & purification
Clostridium perfringens - pathogenicity
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - pathology
DNA, Bacterial - analysis
Enteritis - etiology
Enteritis - pathology
Enteritis necroticans
Fatal Outcome
Female
Humans
Laboratory Medicine
Medicine
Medicine & Public Health
Pathology
Pigbel
Polymerase Chain Reaction
Type C
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Summary:Enteritis necroticans is a segmental necrotizing infection of the jejunum and ileum caused by Clostridium perfringens, Type C. The disease occurs sporadically in parts of Asia, Africa, and the South Pacific, where it primarily affects children with severe protein malnutrition. The disease is extremely rare in developed countries, where it has been seen primarily in diabetics. Two cases have previously been reported in the United States, one in a child with poorly controlled Type 1 diabetes. A 66-year-old woman with a 12-year history of Type 2 diabetes mellitus developed severe abdominal pain and bloody diarrhea after eating a meal of turkey sausage. She died unattended at home. An autopsy showed peritonitis and segmental necrosis of the jejunum and ileum. Microscopic examination showed Gram-positive club-shaped bacilli consistent with Clostridia coating a necrotic mucosa. Products of cpa and cpb genes of C. perfringens, Type C were identified in the necrotic jejunum by polymerase chain reaction amplification.
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.3880491