Sepsis due to Clostridium Clostridioforme bacteremiain a patient with undifferentiated endometrial carcinoma: a case report

Sepsis is a significant non-cancer cause of death in patients with endometrial cancer, with uterine clostridial infections being particularly concerning in these patients. While Clostridium perfringens is more commonly associated with gynecologic infections, this report documents a rare case of Clostridium clostridioforme sepsis in a postmenopausal woman with undifferentiated endometrial carcinoma. The patient was admitted nine days post-biopsy with sepsis. Initial treatment included cefepime, vancomycin, and metronidazole. After identifying Clostridium clostridioforme in blood cultures, vancomycin was discontinued. As her condition worsened, treatment was switched to ampicillin/sulbactam and later vancomycin was re-added, resulting in improvement. She was discharged with oral amoxicillin/clavulanic acid. Despite initial recovery, she was readmitted with severe complications and transitioned to comfort care and passed away. This case highlights the complexity of treating rare infections in immunocompromised patients with malignancies. The rapid progression of C. clostridioforme infection underscores the need for heightened awareness and prompt effective treatment strategies in similar clinical scenarios