ABSTRACT
There have been two major developments in the field of Clostridia and gastrointestinal disease. This chapter presents two diseases, which are Clostridium perfringens enterotoxin-associated diarrhea and neutropenic enterocolitis due to Clostridium septicum. The toxin was identified as C. perfringens enterotoxin by neutralization tests in tissue culture using specific antitoxin and by an enzyme-linked immunoassay. One of the patients was treated with vancomycin but relapsed after treatment. The same serotype of C. perfringens was the cause of the relapse. One of the types of gastrointestinal lesion that has been described in patients with leukemia is necrotizing enterocolitis. The implication of C. septicum in the disease may serve to stimulate a more rational nonsurgical approach to treatment. The use of oral vancomycin and parenteral antibiotics active against anaerobes would seem appropriate. The development of an animal model would greatly facilitate research in confirming the role of C. septicum in neutropenic enterocolitis disease.
