Clostridia are bacteria that commonly reside in the large intestine of healthy adults and newborns. Clostridia also reside in animals, soil, and decaying vegetation.
These bacteria produce spores. Spores are an inactive (dormant) form of bacteria. Spores enable bacteria to survive when environmental conditions are difficult. When conditions are favorable, each spore germinates into an active bacterium and produces toxins. The toxins affect various parts of the body such as the muscles, digestive tract, and tissues.
These bacteria are anaerobes and do not require oxygen to live.
There are many different species of clostridia, but only a few cause infections in people or animals.
Clostridia enter the body in different ways and cause various illnesses depending on the species:
Clostridium botulinum may produce a toxin in food that is then consumed and causes foodborne botulism. In infants, these bacteria are ingested and, in the intestines, can produce toxins that cause infant botulism. Bacteria can also enter the body through a wound and produce toxins that cause wound botulism.
Clostridium perfringens may be consumed in food and produce a toxin in the intestines that causes Clostridium perfringens food poisoning.
Clostridium tetani may enter the body through a wound and produce a toxin that causes tetanus.
Clostridioides difficile, which may already be present in the large intestine, may overgrow after use of antibiotics and produce toxins that cause Clostridioides difficile infection.
Various species of clostridia may enter through a wound and produce a toxin that destroys tissue and causes gas gangrene.
Various species of clostridia can cause infection of the gallbladder and female reproductive organs; Clostridium perfringens is the most common one.
Clostridial food poisoning
Clostridium perfringens and Clostridium botulinum can both cause food poisoning.
Clostridium perfringens food poisoning (a type of gastroenteritis) can develop when people eat food (usually beef) that contains clostridia bacteria. See Clostridium perfringens food poisoning for symptoms, diagnosis, and treatment.
Clostridium botulinum food poisoning can develop when people eat food (usually improperly canned, preserved, or fermented foods) that contains botulinum toxin or, in the case of infant botulism, botulinum bacteria. See Foodborne botulism for symptoms, diagnosis, and treatment.
Although Clostridioides difficile causes intestinal inflammation and diarrhea, it is not considered a cause of food poisoning.
Clostridial abdominal and pelvic infections
Clostridia bacteria, usually Clostridium perfringens, are often involved in abdominal infections, usually with other bacteria (called mixed anaerobic infections).
Clostridia bacteria can infect the intestine, the gallbladder, and organs in the pelvis, such as the uterus, fallopian tubes, and ovaries. Clostridial infection of the uterus occurs most commonly after delivery of a baby, especially after a procedure that is not done under sterile conditions such as an abortion (called septic abortion) or removal of tissue in the uterus (curettage) after a miscarriage.
Clostridial infections of the abdomen and pelvis are serious and sometimes fatal. Clostridia produce large amounts of gas, which can form bubbles and blisters in the infected tissue. Often, the infection blocks small blood vessels, and the infected tissue dies, leading to gas gangrene.
Symptoms include pain and fever. The abdomen is tender to the touch. If the uterus is infected, women may have a foul-smelling, bloody discharge from the vagina. Symptoms can progress to a life-threatening complication called sepsis.
To diagnose clostridial abdominal and pelvic infections, doctors take samples of blood, pus, or infected tissue. These samples are examined and sent to a laboratory where bacteria, if present, can be grown (cultured) and identified. Doctors may take x-rays to check for gas produced by clostridia.
Treatment of clostridial abdominal and pelvic infections involves surgery to remove the infected and dead tissue (called debridement). High doses of antibiotics such as penicillin are given for at least 1 week. Sometimes penicillin is used together with another antibiotic called clindamycin. Sometimes, if an organ (such as the uterus) is badly infected, it is removed. Such treatment can be lifesaving.Treatment of clostridial abdominal and pelvic infections involves surgery to remove the infected and dead tissue (called debridement). High doses of antibiotics such as penicillin are given for at least 1 week. Sometimes penicillin is used together with another antibiotic called clindamycin. Sometimes, if an organ (such as the uterus) is badly infected, it is removed. Such treatment can be lifesaving.
Clostridial necrotizing enteritis, neutropenic enterocolitis, and neonatal necrotizing enterocolitis
Clostridial necrotizing enteritis is also called enteritis necroticans or pigbel. This infection is caused by Clostridium perfringens and typically affects the small intestine, where it can cause tissue death and perforations in the wall of the intestine.
The infection ranges from mild to severe and can be fatal if not treated promptly. This infection occurs mostly in areas where people consume low-protein diets, periodically feast on contaminated meat, have inadequate sanitation, and often already have an ascariasis worm infection, including parts of New Guinea, Africa, Central and South America, and Asia.
Symptoms vary from mild diarrhea to severe abdominal pain, vomiting, bloody stool, septic shock, and sometimes death within 24 hours.
Diagnosis of clostridial necrotizing enteritis is based on symptoms and stool tests.
Treatment of clostridial necrotizing enteritis is with antibiotics. People who have very severe infections may need abdominal surgery.
Neutropenic enterocolitis (typhlitis) is a life-threatening infection that develops in the large intestine of people who have a low white blood cell count (for example, people who have leukemia or are receiving chemotherapy for cancer).
People have fever, abdominal pain, bleeding in the digestive tract, and diarrhea.
The diagnosis of neutropenic enterocolitis is based on symptoms, the white blood cell count, imaging tests of the abdomen, and blood and stool tests.
Treatment of neutropenic enterocolitis is with antibiotics and sometimes surgery.
Neonatal necrotizing enterocolitis in an infection that most commonly occurs in premature newborns. It may be caused by clostridia bacteria.
Clostridia in the bloodstream
Clostridia bacteria may also spread into the blood and cause bacteremia. Bacteremia can trigger a widespread reaction called sepsis. Sepsis can cause fever and serious symptoms such as low blood pressure, jaundice, and anemia. Sepsis can be rapidly fatal.
To confirm sepsis caused by clostridia, doctors take samples of blood. These samples are sent to a laboratory where bacteria, if present, can be grown (cultured) and identified.
People who have sepsis are admitted to the hospital and are given antibiotics. (See also treatment of sepsis.)
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