Abstract
We experienced treating a rare case of Clostridium haemolyticum infection of the bone marrow. There are very few reports of cases in which bone marrow necrosis is diagnosed during the lifetime. This bacterium has been found to cause bacterial hemoglobinuria in domestic animals such as cows or horses. The patient’s main complaints were fever and lower back pain, and he consulted our hospital. He was diagnosed as having diffuse large B-cell lymphoma (DCBCL) and was also suspected of having Burkitt lymphoma. He was treated by chemotherapy. After partial resection of the small intestine with ulcer and hemorrhage, bone marrow necrosis was confirmed. The samples were negative for pathogenic microorganisms on the third culture and a Clostridium sp. was detected on the fourth culture. Because it was difficult for us to identify the species of this bacterium by the anaerobic bacterium identification method in our laboratories and we doubted the possibility of Clostridium tetani, we requested other facilities to identify the bacterium while we treated the patient with penicillin G (PCG), tetanus toxoid, and tetanobulin. As a result of continuous treatment by chemotherapy and myeloid irrigation, his lower back pain improved and the bone marrow culture became negative. It is effective to use other methods of bacterium identification and improve the biochemical properties of culture media to increase the identification rate of bacteria. By this strategy, doctors will be able examine and treat patients in whom the suspected causal anaerobic bacterium is difficult to identify.