Walsh & Hoyt: Clostridium

The genus Clostridium includes 60 species of obligate anaerobic, gram-positive, spore-forming bacilli. Clostridia are ubiquitous, being found in soil, decaying vegetation, marine sediment, and the intestinal tract of humans, other vertebrates, and insects. The most characteristic and well-documented diseases of neurologic and neuro-ophthalmologic importance are the histotoxic clostridial syndromes, tetanus and botulism, in which clostridial toxins are responsible for the pathophysiology and clinical manifestations of the diseases. Clostridia are also commonly recovered from infected sites within the CNS. They are usually a component of a polymicrobial flora, making it difficult to establish their pathogenic role; however, certain species, particularly Clostridium perfringens, Clostridium paraputrificum, and Clostridium septicum, are occasionally the only isolates from CSF in patients with acute meningitis or from brain abscesses. In such cases, it seems likely that they are the causative organism.