Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jan 23;5(2):194-198.
doi: 10.1002/ams2.329. eCollection 2018 Apr.

Necrotizing enterocolitis associated with Clostridium butyricum in a Japanese man

Yukio Sato  1   2 , Dai Kujirai  1   2 , Katsura Emoto  3   4 , Toshiaki Yagami  5 , Taketo Yamada  3   4   6 , Manabu Izumi  7 , Masaki Ano  8 , Kenichi Kase  1 , Kenji Kobayashi  1   9
Affiliations
Case Reports

Necrotizing enterocolitis associated with Clostridium butyricum in a Japanese man

Yukio Sato et al. Acute Med Surg. .

Abstract

Case: Necrotizing enterocolitis (NEC) caused by Clostridium butyricum is common in neonates; however, a case of NEC in adults has not been previously reported. An 84-year-old Japanese man developed C. butyricum-related NEC during hospitalization for treatment of stab wounds to the left side of the neck and lower abdomen, without organ damage, and concomitant pneumonia.

Outcome: The patient developed acute onset of emesis accompanied by shock during his admission; partial resection of the small intestine was carried out due to necrosis. Pathologic findings showed mucosal necrosis and extensive vacuolation with gram-positive rods in the necrotic small intestine. Blood culture tests revealed C. butyricum infection. The patient's condition improved after the surgery. He was moved to a rehabilitation hospital on day 66.

Conclusion: This study suggests that hospitalized adult patients who receive antibiotic treatment are at risk for NEC.

Keywords: Adult; Asia; Clostridium butyricum; enterocolitis; necrotizing.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Radiographs and whole body computed tomography (CT) scans taken on admission of an 84‐year‐old man with self‐inflicted stab wounds to the neck and abdomen. A, Radiograph of the chest. B, Radiograph of the neck. C, CT image of the chest. Arrows indicate the air leakage. D, CT image of the abdomen. The arrow indicates the injury to the posterior layer of the rectus sheath.
Figure 2
Figure 2
Whole body computed tomography scan of an 84‐year‐old man with self‐inflicted stab wounds to the neck and abdomen, taken when the patient presented with vomiting. A, Image of the upper abdomen. Arrows indicate portal vein gas. B, Image of the lower abdomen. Arrows indicate pneumatosis cystoides intestinalis.
Figure 3
Figure 3
Histological observation of the resected small intestine of an 84‐year‐old man with necrotizing enterocolitis associated with Clostridium butyricum, using hematoxylin–eosin staining with a macro image. A, Macro image of resected tract. Arrow indicates the oral side. B, Severe inflammation, several vacuoles, congestion, and hemorrhage in the muscularis propria and subserosal layer indicate gas gangrene. Scale bar, 500 μm. C, Vacuoles are surrounded by acute severe inflammation and considered as gas accumulation. Scale bar, 100 μm. D, Observation by oil immersion lens reveals numerous bacilli adjacent to vacuoles. Scale bar, 20 μm.
See this image and copyright information in PMC

References

    1. Benno Y, Sawada K, Mitsuoka T. The intestinal microflora of infants: composition of fecal flora in breast‐fed and bottle‐fed infants. Microbiol. Immunol. 1984; 28: 975–86. - PubMed
    1. Isa K, Oka K, Beauchamp N et al Safety assessment of the Clostridium butyricum MIYAIRI 588(R) probiotic strain including evaluation of antimicrobial sensitivity and presence of Clostridium toxin genes in vitro and teratogenicity in vivo . Hum. Exp. Toxicol. 2016; 35: 818–32. - PubMed
    1. Woo TD, Oka K, Takahashi M et al Inhibition of the cytotoxic effect of Clostridium difficile in vitro by Clostridium butyricum MIYAIRI 588 strain. J. Med. Microbiol. 2011; 60: 1617–25. - PubMed
    1. Imase K, Takahashi M, Tanaka A et al Efficacy of Clostridium butyricum preparation concomitantly with Helicobacter pylori eradication therapy in relation to changes in the intestinal microbiota. Microbiol. Immunol. 2008; 52: 156–61. - PubMed
    1. Cassir N, Benamar S, Khalil JB et al Clostridium butyricum strains and Dysbiosis linked to necrotizing enterocolitis in preterm neonates. Clin. Infect. Dis. 2015; 61: 1107–15. - PubMed

Publication types

LinkOut - more resources