C. perfringens food poisoning is usually a mild clostridial infection.
C. perfringens is widely distributed in feces, soil, air, and water. Contaminated meat has caused many outbreaks. C. perfringens spores sometimes survive cooking; they can germinate and multiply, resulting in large numbers of bacteria when cooked meat that is contaminated with C. perfringens is left at room temperature or even up to 60° C (140° F, as on a warming table) for a period of time. Outbreaks typically occur in commercial establishments and rarely at home.
Once inside the gastrointestinal tract, C. perfringens produces an enterotoxin that acts on the small bowel. Only C. perfringens type A has been definitively linked to this food poisoning syndrome.
Mild gastroenteritis is most common, with onset of symptoms 6 to 24 hours after ingestion of contaminated food. The most common symptoms are watery diarrhea and abdominal cramps. Vomiting and fever are unusual. Symptoms typically resolve within 24 hours; severe or fatal cases rarely occur.
Diagnosis of C. perfringens food poisoning is based on epidemiologic evidence and isolation of large numbers of organisms from contaminated food or from stools of affected people or on direct identification of enterotoxin in stool samples.