Clostridium perfringens: What It Is, Symptoms, and Treatment - Verywell Health
Clostridium perfringens is a bacterium that can cause an infection in the gastrointestinal tract or skin and deep tissues. The effects are different in both systems. Clostridium perfringens is one of the most common foodborne causes of diarrhea caused by food poisoning. It can also cause chronic diarrhea in people who take antibiotics often.
However, the most concerning infection with Clostridium perfringens is of the skin and deep tissues. Here, the bacterium causes muscle and tissue death called gas gangrene.
This article will discuss Clostridium perfringens, where it can be found, and the symptoms associated with the bacterial infections it causes. Also, discover treatments and ways to prevent infections.
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What Is Clostridium Perfringens?
Clostridium perfringens is a spore-forming bacterium that causes the following three illnesses:
- Foodborne illness: Clostridium perfringens is a common cause of foodborne illness (food poisoning) in the United States, with nearly 1 million cases yearly.
- Non-foodborne gastrointestinal infection: This type of infection is often attributable to antibiotic use. But some people can also develop sporadic gastrointestinal symptoms from Clostridium perfringens, even when not taking antibiotics. People with weakened immune systems are most at risk for this type of illness.
- Skin and deep tissue infection: Clostridium perfringens is associated with a severe skin and deep tissue infection (gas gangrene) that a person can develop after a significant traumatic injury.
What Is Unique About Spores?
Bacteria that produce spores can survive in extreme environments, such as in nutrient-lacking soil or environments with extreme temperatures.
Where Is the Bacterium Found?
Clostridium perfringens can be found in:
- Raw meat
- Poultry
- Soups
- Sauces
- Gravies
- Raw vegetables
- Spices
The bacterium and its spores become a problem to people when food is not cooked correctly or not refrigerated shortly after cooking.
Outbreaks among several people typically occur in large-group settings where food is catered or cooked in large batches. Several outbreaks have been linked to holiday celebrations in which people ingest contaminated turkey or roast beef.
History
Clostridium perfringens has been around for a very long time. It was detected in the gastrointestinal tract of a more than 5,000-year-old mummified remains of the Neolithic "Iceman" found in an Alpine glacier.
Clostridium perfringens is a regular resident of the gastrointestinal tracts of humans and animals. It and other bacterial species make up the microbiota of the intestines. These microbes live in harmony in the gut, assist digestion, and do not cause harm as long as they remain balanced.
However, when a person consumes antibiotics, certain bacteria die, leading to an imbalance of the microbiota and gastrointestinal symptoms from the overgrowth of one bacterial species, like Clostridium perfringens.
Clostridium perfringens is also found in the soil. People come into contact with the organism often, but the bacteria thrive more when the environment (the skin and tissue) lacks oxygen (is anaerobic).
This anaerobic environment is created when a person suffers a significant traumatic injury in which the blood supply is cut off from the tissues, such as from gunshot wounds, stabbings, and severe bone fractures. This type of Clostridium infection (Clostridium myonecrosis, also known as gas gangrene) is rare.
Symptoms of Infection
The symptoms differ by the type of infection with Clostridium perfringens.
Foodborne Infection
Foodborne Clostridium perfringens leads to:
- Diarrhea
- Abdominal cramps
- Gas and bloating
The bacterium can grow on raw meat and poultry. It can multiply rapidly if the food is not cooked correctly. When someone swallows the bacteria while eating undercooked food, bacterial toxin leads mainly to diarrhea.
Typically, people develop symptoms shortly after ingesting the bacteria and its spores, usually within six to 24 hours. Diarrhea begins suddenly but usually symptoms resolve in 24 to 48 hours.
Other Causes of Food Poisoning
Other bacteria that can lead to foodborne outbreaks of diarrhea are Bacillus cereus and Staphylococcus aureus.
Non-Foodborne Gastrointestinal Infection
Non-foodborne Clostridium perfringens gastrointestinal infection leads to:
This type of Clostridium perfringens infection typically occurs in adults over age 60 who have recently taken antibiotics. The symptoms are similar to foodborne Clostridium infection but last anywhere from three days to several weeks.
This type of Clostridium infection can lead to severe dehydration (loss of water from the body). However, people usually recover.
Skin and Tissue Infection
Clostridium perfringens infection of the skin or deep tissues (gas gangrene) leads to:
- Rapidly developing severe pain
- Fever
- Fatigue
- Pale skin that becomes red and swollen and then quickly develops into black, necrotic (dead) tissue
- Skin blisters and bullae (very large blisters)
- Crepitus (gas under the skin and inside the muscle)
- Foul-smelling discharge from the infection site
Clostridium Species That Commonly Cause Gas Gangrene
Two notable species of Clostridium lead to gas gangrene: Clostridium perfringens and Clostridium septicum. Clostridium perfringens is more often associated with trauma.
Clostridium septicum usually develops in individuals with a suppressed immune system and cancer of the colon or rectum. It also occurs in individuals with blood cancers (like leukemia), inflammatory bowel disease, diverticulitis, lymphoproliferative disorders, cyclic neutropenia, human immunodeficiency virus (HIV), or AIDS. Individuals who have undergone radiation therapy or gastrointestinal surgery may also be at risk.
It is thought the infection enters the bloodstream through an injury or lesion within the gastrointestinal system where it is carried to other tissues of the body including deep muscle tissue.
This type of Clostridium perfringens infection is the worst kind and the kind that emergency physicians and surgeons fear finding. Only a small number of bacteria are needed to cause this type of infection.
One of the hallmarks of gas gangrene is pain that is out of proportion to what is seen in a skin examination. This means the pain can be unbearable with minimal signs of infection.
Unfortunately, these bacteria reproduce rapidly. They release a toxin that produces gas in the tissues, which contributes to necrosis (death of the tissue). People can quickly become extremely ill and develop sepsis (a whole-body reaction to a bacterial infection), multi-organ failure, and death.
How to Treat Clostridium Perfringens
Typically, people who develop diarrhea from Clostridium perfringens never receive an official diagnosis because the symptoms are so short-lived.
However, it is important to keep yourself hydrated by drinking plenty of fluids when diarrhea occurs. People typically do not have a fever or vomiting that would contribute to significant dehydration. Generally, people recover without further treatment.
Testing
Testing for Clostridium perfringens is rarely performed. The Centers for Disease Control and Prevention (CDC) only accepts specimens for testing when a foodborne outbreak is suspected.
Clostridium perfringens myonecrosis is a medical emergency. People require intravenous antibiotics. The first-line treatment is penicillin plus clindamycin.
These people will also need surgery to remove infected and dead tissue from the affected area. Sometimes, when the infection has spread too deep into the muscle, the disease requires an amputation.
How to Prevent Infection
To avoid foodborne Clostridium perfringens diarrhea, it is essential to:
- Thoroughly cook food to a safe temperature.
- Keep food warm at 140 degrees Fahrenheit or higher after it is cooked, or refrigerate it soon afterward (within two hours, or within one hour if the outside temperature is above 90 degrees).
- Refrigerate leftovers at a temperature of less than 40 degrees.
- Properly reheat leftovers to at least 165 degrees before serving.
To avoid non-foodborne Clostridium perfringens, try to limit antibiotic usage.
To avoid Clostridium perfringens infection of the skin, have all major traumatic injuries evaluated by a healthcare provider and thoroughly cleaned. This advice is crucial for people with weakened immune systems or diabetes.
Summary
Clostridium perfringens is a bacteria that is a common cause of food poisoning in the United States. The organism can also cause non-foodborne diarrhea related to antibiotic use. It also can cause a severe skin and deep tissue infection called gas gangrene.
The bacteria normally live in the gut of humans and animals. They can grow on raw meat, in sauces, and in extreme environments, such as nutrient-lacking soil and extreme temperatures.
Clostridium perfringens often leads to diarrhea, and the illness resolves within 24 hours. The most concerning form of the infection, gas gangrene, is rare but life-threatening.
The only treatment required for food poisoning related to Clostridium perfringens is oral rehydration. Antibiotics against the bacteria would only be necessary for a severe illness like gas gangrene. To prevent infection, it is vital to store and cook food properly. It is also important to clean your wounds.
A Word From Verywell
There are three major types of infection from Clostridium perfringens. Foodborne infection is not something to worry much about. Non-foodborne infection doesn't happen often and should only be a consideration if you have had prolonged diarrhea. The third type of infection can be severe and life-threatening.
Food poisoning is extremely common and probably underreported since symptoms resolve on their own. There's always a chance that you have Clostridium perfringens if you develop diarrhea shortly after eating. However, your symptoms will likely resolve quickly, and you'll be fine.
The type of Clostridium perfringens to be concerned about involves severe wounds, especially in people with weakened immune systems who do not heal well. If you have a significant wound or injury, it should be evaluated by a healthcare provider and thoroughly cleaned.
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