散播性肉毒桿菌感染是罕見的且與惡性腫瘤有關的併發症，尤其是結腸腺癌。該菌似乎會優先在少數人的大腫瘤中殖入，然後通過黏膜潰瘍途徑將血液侵染植入。這很少報告會導致中樞神經系統感染，並在幾種情況下迅速進展為腦內氣腫。在少數報告中，這是一種普遍致命的疾病。目前的病例增加了對這種極其罕見併發症的報告，並提供了獨特和完整的臨床病理描述，包括屍檢，顯微鏡檢查和分子檢測。 一名年輕60歲且沒有已知病史的男性被發現具有類癫癇活動和中風症狀。六小時後，血液培養轉陽性。影像學顯示大而不規則的盲腸腫瘤以及左側頂葉1.4厘米的空氣集合，8小時內進展到7厘米以上。隔天早上，病人失去所有神經反射並去世。尸检顯示腦組織具有多個明顯囊腫和腦實質內出血，而顯微鏡檢查顯示散在缺血缺氧損傷和革蘭氏陽性桿菌。肉毒桿菌感染被識別在血液培養中，並通過16S核糖體序列技術從大腸中證實。C. septicum是嗜厭氧的革蘭氏陽性桿菌，能夠成為侵襲性病原菌，並與胃腸道病理學，包括結腸腺癌有很強的相關性。與散播性C. septicum感染相關的中樞神經系統感染和迅速進展的腦內氣腫是罕見的，但普遍致命的併發症。 ©2023. 作者（們）。

Disseminated Clostridium septicum infection is an uncommon complication associated with malignancies, particular colonic adenocarcinoma. The organism appears to preferentially colonize large masses in rare individuals and subsequently seed the blood via mucosal ulceration. This has rarely been reported to lead to central nervous system infection and, in several cases, rapidly progressive pneumocephalus. In the few cases reported, this was a universally fatal condition. The current case adds to the reports of this extremely rare complication and provides a unique and complete clinicopathologic characterization with autopsy examination, microscopy, and molecular testing.A 60-year-old man with no known past medical history was discovered having seizure-like activity and stroke-like symptoms. Blood cultures turned positive after six hours. Imaging revealed a large, irregular cecal mass as well as 1.4 cm collection of air in the left parietal lobe that progressed to over 7 cm within 8 h. By the following morning, the patient had lost all neurologic reflexes and died. Post-mortem examination revealed brain tissue with multiple grossly evident cystic spaces and intraparenchymal hemorrhage, while microscopic exam showed diffuse hypoxic-ischemic injury and gram-positive rods. Clostridium septicum was identified on blood cultures and was confirmed in paraffin embedded tissue from the brain by 16 S ribosomal sequencing and from the colon by C. septicum specific PCR.C. septicum is an anaerobic, gram-positive rod that can become invasive and is strongly associated with gastrointestinal pathology including colonic adenocarcinomas. Central nervous system infection with rapidly progressive pneumocephalus is a rarely reported and universally fatal complication of disseminated C. septicum infection.© 2023. The Author(s).