Prosthetic joint infections (PJIs) commonly result from aerobic gram-positive organisms and can lead to detrimental outcomes. However, it is rare for Clostridium perfringens to cause a PJI. Owing to its rarity, current literature lacks a comprehensive guide for the proper management of these PJIs. We report on the case of an 80-year old man who presented to our institution with concerns for sepsis secondary to a PJI with C. perfringens 25 years status post total knee arthroplasty. The patient was managed with two-stage revision and exchange. After stage one, the patient developed cholecystitis, which has been reported in prior cases of PJI due to C. perfringens. After concerns for sepsis had resolved and stage 1 was complete, the patient was managed with 6 weeks of IV antibiotics. Treatment was directed at gram-positives with IV vancomycin along with anerobic coverage determined by anerobic susceptibility testing. After the second stage, the patient was discharged with 3 months of oral antibiotic therapy. At the final 1-year follow-up, the patient was doing well without residual infection. This report reviews previous evidence on the management of C. perfringens PJI and presents a case demonstrating the successful diagnostic, surgical, and antimicrobial management of a PJI with C. perfringens.

Herpes Simplex Virus esophagitis typically manifests as mucocutaneous lesions in immunocompromised patients, most frequently in organ and bone marrow transplant recipients. However, it has not been appropriately reported as a cause of febrile neutropenia despite being a relatively common opportunistic infection in this patient population. A 58-year-old man recently diagnosed with Ewing Sarcoma for which he was receiving chemotherapy presented with febrile neutropenia. Following a prolonged hospital course characterized by persistent fevers, an endoscopic evaluation was performed and diagnosis of Herpes Simplex Virus esophagitis was confirmed via histopathology. Prompt administration of acyclovir resulted in the complete resolution of the patient’s symptoms. Recognition of Herpes Simplex Virus esophagitis as an etiology of febrile neutropenia can ensure more prompt diagnosis and allow for appropriate management of these patients. In addition, this case report emphasizes a need for further research into additional diagnostic markers in the workup of these patients and the incorporation of antiviral therapy in febrile neutropenia algorithms.

Necrotizing pneumonia is a life-threatening complication of community-acquired pneumonia managed in an intensive care setting with a multitude of diagnosti