Leaky Gut Syndrome Along With Clostridium perfringens Bacteremia in a Neurodegenerative Disease Patient: A Case Report

Leaky gut syndrome (LGS) is caused by intestinal epithelial injury and increased intestinal permeability due to a variety of factors, including chronic stress, inflammatory bowel disease, diabetes, surgery, and chemotherapy, resulting in an increased influx of matter from the intestinal lumen causing constipation and bacteremia. To our knowledge, this is the first known case of LGS along with <i>Clostridium perfringens</i> (<i>C. perfringens</i>) bacteremia in a neurodegenerative disease patient. The patient was an 81-year-old male with a history of Alzheimer's disease, cerebral infarction, and diverticulitis in a psychiatric hospital, fed via a nasogastric tube. During hospitalization, he developed a 37.4℃ temperature and disturbance of consciousness evaluated as 3 points on the Glasgow Coma Scale. A follow-up blood examination revealed a white blood cell count of 29,000/µL and a C-reactive protein value of 11.2 mg/dL. Computed tomography revealed an increased concentration of peripheral adipose tissue from the sigmoid colon to the rectum and significant quantities of stool in the rectum. Treatment was initiated with doripenem (DRPM) for sepsis of unknown focus. <i>C. perfringens</i> was subsequently identified in both two blood culture tests. He improved with decreased inflammatory response; DRPM was terminated after 14 days. He remains free of recurrence. We speculate that the LGS in this case may have developed from dopaminergic neuronal decrease and impaired amino acid metabolism caused by chronic hypo-inflammation due to neurodegenerative disease (Alzheimer's disease). We report the first known case of LGS along with <i>C. perfringens</i> bacteremia in a neurodegenerative disease patient.