Editing Clostridium perfringens (section)

==Infection==
Tissue [[necrosis]], [[bacteremia]], emphysematous [[cholecystitis]], and [[gas gangrene]], also known as clostridial [[myonecrosis]], have been linked to infections associated with ''C. perfringens''.<ref name=":32" /> Research suggests that ''C. perfringens'' is capable of engaging in polymicrobial [[anaerobic infection]]s.<ref name=":42">{{Cite journal |last1=Takehara |first1=Masaya |last2=Takagishi |first2=Teruhisa |last3=Seike |first3=Soshi |last4=Ohtani |first4=Kaori |last5=Kobayashi |first5=Keiko |last6=Miyamoto |first6=Kazuaki |last7=Shimizu |first7=Tohru |last8=Nagahama |first8=Masahiro |date=2016-06-16 |title=Clostridium perfringens α-Toxin Impairs Innate Immunity via Inhibition of Neutrophil Differentiation |journal=Scientific Reports |language=en |volume=6 |issue=1 |page=28192 |bibcode=2016NatSR...628192T |doi=10.1038/srep28192 |issn=2045-2322 |pmc=4910053 |pmid=27306065}}</ref>

''Clostridium perfringens'' is a common cause of food poisoning in the United States. ''C. perfringens'' produces spores, and when these [[spore]]s are consumed, they produce a toxin that causes diarrhea. Foods cooked in large batches and held at unsafe temperatures (between 40&nbsp;°F and 140&nbsp;°F) are the source of ''C. perfringens'' food poisoning outbreaks. Meats such as poultry, beef, and pork are commonly linked to ''C. perfringens'' food poisoning.<ref>{{Cite web |last=CDC |date=2024-05-16 |title=About C. perfringens food poisoning |url=https://www.cdc.gov/clostridium-perfringens/about/index.html |access-date=2024-11-20 |website=Clostridium perfringens Food Poisoning |language=en-us}}</ref> ''C. perfringens'' can proliferate in foods that are improperly stored due to the spore's ability to survive normal cooking temperatures. The type A toxin of ''C. perfringens'', also known as the CPA is responsible for food poisoning.<ref>{{Citation |last1=Yao |first1=Phil Y. |title=Clostridium perfringens Infection |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK559049/ |access-date=2024-11-20 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32644475 |last2=Annamaraju |first2=Pavan}}</ref>

''Clostridium perfringens'' is the most common bacterial agent for [[gas gangrene]].<ref name=":2">{{cite web |title=Gas gangrene: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/000620.htm}}</ref> Gas gangrene is induced by [[Clostridium perfringens alpha toxin|α-toxin]] that embeds itself into the plasma membrane of cells and disrupts normal cellular function by altering membrane structure.<ref name=":32"/> Some symptoms include blisters, tachycardia, swelling, and jaundice.<ref name=":2" />

''C. perfringens'' is most commonly known for foodborne illness but can translocate from a gastrointestinal source into the bloodstream which causes [[bacteremia]]. ''C. perfringens'' bacteremia can lead to toxin-mediated intravascular hemolysis and septic shock.<ref>{{Cite journal |date=2023-06-03 |title=Cytarabine |url=http://dx.doi.org/10.1007/s40278-023-40395-7 |journal=Reactions Weekly |volume=1959 |issue=1 |pages=223 |doi=10.1007/s40278-023-40395-7 |issn=1179-2051 |s2cid=259027022|url-access=subscription }}</ref> This is rare as it makes up less than 1% of bloodstream isolates but is highly fatal with a reported mortality rate of 27% to 58%.<ref>{{Cite journal |last1=Millard |first1=Michael A. |last2=McManus |first2=Kathleen A. |last3=Wispelwey |first3=Brian |date=2016 |title=Severe Sepsis due to Clostridium perfringens Bacteremia of Urinary Origin: A Case Report and Systematic Review |journal=Case Reports in Infectious Diseases |language=en |volume=2016 |pages=1–5 |doi=10.1155/2016/2981729 |issn=2090-6625 |pmc=4779822 |pmid=26998370 |doi-access=free}}</ref>

''Clostridium perfringens'' food poisoning can also lead to another disease known as enteritis necroticans or [[clostridial necrotizing enteritis]], (also known as pigbel); this is caused by ''C. perfringens'' type C. This infection is often fatal. Large numbers of ''C. perfringens'' grow in the intestines and secrete exotoxin. This exotoxin causes necrosis of the intestines, varying levels of hemorrhaging, and perforation of the intestine. Inflammation usually occurs in sections of the jejunum, midsection of the small intestine.<ref name="Lentino-2016">{{Cite web |last=Lentino |first=Joseph R. |date=2016-01-01 |title=Clostridial Necrotizing Enteritis |url=http://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/clostridial-necrotizing-enteritis |access-date=2016-09-27 |website=Merck Manuel |publisher=Merck Sharp & Dohme Corp.}}</ref> [[Cytolysin|Perfringolysin O]] (''pfoA'')-positive ''C. perfringens'' strains were also associated with the rapid onset of [[necrotizing enterocolitis]] in preterm infants.<ref>{{Cite journal |last1=Kiu |first1=Raymond |last2=Shaw |first2=Alexander G. |last3=Sim |first3=Kathleen |last4=Acuna-Gonzalez |first4=Antia |last5=Price |first5=Christopher A. |last6=Bedwell |first6=Harley |last7=Dreger |first7=Sally A. |last8=Fowler |first8=Wesley J. |last9=Cornwell |first9=Emma |last10=Pickard |first10=Derek |last11=Belteki |first11=Gusztav |last12=Malsom |first12=Jennifer |last13=Phillips |first13=Sarah |last14=Young |first14=Gregory R. |last15=Schofield |first15=Zoe |date=June 2023 |title=Particular genomic and virulence traits associated with preterm infant-derived toxigenic Clostridium perfringens strains |journal=Nature Microbiology |language=en |volume=8 |issue=6 |pages=1160–1175 |doi=10.1038/s41564-023-01385-z |issn=2058-5276 |pmc=10234813 |pmid=37231089}}</ref>

A strain of ''C. perfringens'' might be implicated in [[multiple sclerosis]] (MS) nascent ([[Balo concentric sclerosis|Pattern III]]) lesions.<ref>{{cite journal |last1=Rumah |first1=Kareem Rashid |last2=Linden |first2=Jennifer |last3=Fischetti |first3=Vincent A. |last4=Vartanian |first4=Timothy |last5=Esteban |first5=Francisco J. |date=16 October 2013 |title=Isolation of Clostridium perfringens Type B in an Individual at First Clinical Presentation of Multiple Sclerosis Provides Clues for Environmental Triggers of the Disease |journal=PLOS ONE |volume=8 |issue=10 |pages=e76359 |bibcode=2013PLoSO...876359R |doi=10.1371/journal.pone.0076359 |pmc=3797790 |pmid=24146858 |doi-access=free}}</ref> Tests in [[Laboratory mouse|mice]] found that two strains of intestinal ''C. perfringens'' that produced epsilon toxins (ETX) caused MS-like damage in the brain, and earlier work had identified this strain of ''C. perfringens'' in a human with MS.<ref>{{cite web |date=29 January 2014 |title=Multiple sclerosis 'linked to food bug' |url=https://www.bbc.co.uk/news/health-25925658 |access-date=29 January 2014 |publisher=BBC}}</ref><ref>{{Cite journal |last=Reder |first=Anthony T. |date=2023-05-01 |title=Clostridium epsilon toxin is excessive in multiple sclerosis and provokes multifocal lesions in mouse models |journal=Journal of Clinical Investigation |language=en |volume=133 |issue=9 |doi=10.1172/JCI169643 |issn=1558-8238 |pmc=10145922 |pmid=37115699 |s2cid=258375399 |doi-access=free}}</ref> MS patients were found to be 10 times more likely<ref>{{cite journal |last1=Rumah |first1=Kareem Rashid |last2=Linden |first2=Jennifer |last3=Fischetti |first3=Vincent A. |last4=Vartanian |first4=Timothy |title=Isolation of Clostridium perfringens Type B in an Individual at First Clinical Presentation of Multiple Sclerosis Provides Clues for Environmental Triggers of the Disease |journal=PLOS ONE |date=16 October 2013 |volume=8 |issue=10 |pages=e76359 |doi=10.1371/journal.pone.0076359|doi-access=free |pmid=24146858 |pmc=3797790 |bibcode=2013PLoSO...876359R }}</ref> to be immune-reactive to the epsilon toxin than healthy people.<ref>{{cite web |last=Woerner |first=Amanda |date=29 January 2014 |title=Bacterial toxin may trigger multiple sclerosis, research finds |url=https://www.foxnews.com/health/bacterial-toxin-may-trigger-multiple-sclerosis-research-finds/?intcmp=trending |website=[[Fox News]]}}</ref> Greatly increased rates of gut colonization by type B and D ''C. perfringens'' are seen in MS patients.<ref>{{cite journal |last1=Reder |first1=AT |title=Clostridium epsilon toxin is excessive in multiple sclerosis and provokes multifocal lesions in mouse models. |journal=The Journal of Clinical Investigation |date=1 May 2023 |volume=133 |issue=9 |doi=10.1172/JCI169643 |pmid=37115699 |pmc=10145922}}</ref>

Tissue gas occurs when ''C. perfringens'' infects corpses. It causes extremely accelerated decomposition and can only be stopped by [[embalming]] the corpse. Tissue gas most commonly occurs to those who have died from gangrene, large [[decubitus]] ulcers, necrotizing fasciitis or to those who had soil, feces, or water contaminated with ''C. perfringens'' forced into an open wound.<ref>{{cite web |title=Clostridium perfringens |url=https://ldh.la.gov/assets/oph/Center-PHCH/Center-CH/infectious-epi/EpiManual/ClostridiumPerfringensManual.pdf |website=ldh.la.gov/ |publisher=Louisiana Office of Public Health |access-date=14 June 2024}}</ref>