Postoperative Clostridium tertium septicemia in a non-neutropenic pediatric patient

Clostridium tertium (C. tertium) septicemia is rare, and most cases are observed in neutropenic patients. Our case was a non-neutropenic 7-month-old male who underwent anorectal surgery. On postoperative day 2, his body temperature increased to 40.0°C and gram-positive bacilli were isolated from the aerobic blood culture. We started empiric antibiotic therapy with meropenem. Because the strain was initially identified as Listeria grayi, we switched to ampicillin following susceptibility testing. However, the sequence analysis of the 16S-rRNA gene showed 99% similarity to C. tertium. Here we review the characteristics and management of C. tertium septicemia in non-neutropenic patients.