{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:00:37Z","timestamp":1779328837998,"version":"3.51.4"},"reference-count":10,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,2,28]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>We report the case of a 76-year-old female patient with early breast cancer (hormone receptor-positive erbb2 amplified) that had started adjuvant chemotherapy with docetaxel, carboplatin and trastuzumab (TCH). Eight days after the first cycle of TCH chemotherapy, the patient was diagnosed with grade 1 oral mucositis, treated conservatively. The next day she started with nausea, vomiting, chills and fever, followed by a generalised tonicoclonic seizure. She presented to the emergency department with fever, hypotension and mild abdominal tenderness. Grade 4 neutropenia (370 \u03bcL\/mL) and severe metabolic acidosis were documented. An abdominal CT scan documented extensive ischaemic bowel changes, with gas in portal and mesenteric veins, and pneumoretroperitoneum. Despite broad spectrum antibiotics and fluid resuscitation, she died 4\u2009hours after admitted to hospital. Blood cultures collected on hospital admission eventually grew <jats:italic>Clostridium septicum<\/jats:italic> bacteria, an extremely rare infection in patient with breast cancer.<\/jats:p>","DOI":"10.1136\/bcr-2019-233778","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T05:51:43Z","timestamp":1590040303000},"page":"e233778","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Fatal <i>Clostridium septicum<\/i> febrile neutropenia during adjuvant chemotherapy for early breast cancer"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8981-3272","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Moreira-Pinto","sequence":"first","affiliation":[{"name":"Department of Oncology, Hospital Beatriz \u00c2ngelo, Loures, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Lu\u00eds","family":"Passos-Coelho","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hospital Beatriz \u00c2ngelo, Loures, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hospital Beatriz \u00c2ngelo, Loures, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Ata\u00edde","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Beatriz \u00c2ngelo, Loures, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Beatriz \u00c2ngelo, Loures, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"2025082707052591000_13.5.e233778.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910383"},{"key":"2025082707052591000_13.5.e233778.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.10.013"},{"key":"2025082707052591000_13.5.e233778.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2958.2005.04774.x"},{"key":"2025082707052591000_13.5.e233778.4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-1433.2001.02231.x"},{"key":"2025082707052591000_13.5.e233778.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(05)80023-6"},{"key":"2025082707052591000_13.5.e233778.6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4081\/cp.2011.e33","article-title":"Fulminating septic shock from Clostridium perfringens in an early breast cancer patient with severe myalgia after docetaxel treatment","volume":"1","author":"Minisini","year":"2011","journal-title":"Clin Pract"},{"key":"2025082707052591000_13.5.e233778.7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jinf.2011.09.004","article-title":"Lethal human neutropenic entercolitis caused by Clostridium chauvoei in the United States: tip of the iceberg?","volume":"64","author":"Weatherhead","year":"2012","journal-title":"J Infect"},{"key":"2025082707052591000_13.5.e233778.8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4172\/1948-5956.1000048","article-title":"Neutropenic enterocolitis as possible complication of docetaxel and epirubicin chemotherapy for breast cancer: report of 3 cases","volume":"3","author":"Lombardi","year":"2010","journal-title":"J Cancer Sci Ther"},{"key":"2025082707052591000_13.5.e233778.9","first-page":"527","article-title":"Neutropenic enterocolitis associated with docetaxel therapy in a patient with breast cancer","volume":"7","author":"Rolston","year":"2009","journal-title":"Clin Adv Hematol Oncol"},{"key":"2025082707052591000_13.5.e233778.10","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026437731354"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-233778","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:05:34Z","timestamp":1756303534000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-233778"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":10,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,20]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1136\/bcr-2019-233778"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-233778","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}