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Pathophysiology, clinical clues, and recovery of organisms in anaerobic infections

Author
John G Bartlett, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Anna R Thorner, MD

INTRODUCTION

Anaerobic bacteria are the major constituents of normal human flora and have been recovered from a wide array of different infections. Isolating the organisms from specimens required discovery of specialized methods in the microbiology laboratory, but it has been more problematic to determine when these bacteria represent true pathogens or merely commensals.

The pathophysiology of anaerobic infections, clinical clues to suspect anaerobes, and methods for recovering the organisms will be reviewed here. Clinical syndromes, history, and the composition of the normal flora are discussed separately. (See "Anaerobic bacterial infections" and "Anaerobic bacteria: History and role in normal human flora".)

PATHOPHYSIOLOGY OF ANAEROBIC INFECTIONS

Anaerobic infections nearly always arise from leakage of endogenous bacteria into contiguous or other sites. Important exceptions are some of the clostridial syndromes, including botulism, Clostridium perfringens food poisoning, enteritis necroticans, tetanus, some cases of gas gangrene, and Clostridium difficile–associated diarrhea. (See related topics.)

The usual pathophysiologic mechanism for anaerobic infection is a breach in the mucocutaneous barrier resulting in displacement of the normal flora. Host defense mechanisms are presumably important, but the compromised host is not unusually susceptible. Exceptions are infections associated with defects of mucocutaneous barriers, such as carcinoma with obstruction, mucositis, perirectal lesions, or compromised consciousness with aspiration.

Three major issues arise in the pathogenesis of anaerobic infections:

                   

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Literature review current through: Nov 2016. | This topic last updated: Mon Aug 10 00:00:00 GMT+00:00 2015.
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