Clostridial infection of a locally recurrent renal cell carcinoma with sepsis.

An association between clostridial sepsis and malignancy is well established in the literature. Although anaerobes are a relatively infrequent cause of renal abscess, there have been recent reports of anaerobic abscesses occurring in renal tumor masses. The present report describes a case of sepsis due to Clostridium perfringens infection of a locally recurrent renal cell carcinoma. The infection may have originated either from tumor invasion of the adjacent bowel or by hematogenous seeding of the mass at the time of colonoscopy. Patients with bulky, necrotic tumors who have invasive diagnostic procedures relating to either the gastrointestinal or urogenital tracts, as well as those having malignancies involving these systems, are at increased risk of infection with bowel anaerobes. Clostridial abscesses with accompanying sepsis occur in this setting, and empiric antibiotic regimens should include coverage for these organisms. Early, aggressive surgical intervention is essential.