Clostridium perfringens {beta}-toxin binding to vascular endothelial cells in a human case of enteritis necroticans

1 Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Switzerland 2 Laboratorium Pathologie Oost Nederland, Enschede, The Netherlands Correspondence Horst Posthaus horst.posthaus{at}itpa.unibe.ch Received November 17, 2008 Accepted February 6, 2009 Clostridium perfringens type C-induced enteritis necroticans is a rare but often fatal disease in humans. A consistent histopathological finding is an acute, deep necrosis of the small intestinal mucosa associated with acute vascular necrosis and massive haemorrhage in the lamina propria and submucosa. Retrospective immunohistochemical investigations of tissues from a diabetic adult who died of enteritis necroticans revealed endothelial localization of C. perfringens β -toxin in small intestinal lesions. Our results indicate that vascular necrosis might be induced by a direct interaction between C. perfringens β -toxin and endothelial cells and that targeted disruption of endothelial cells plays a role in the pathogenesis of enteritis necroticans. Supplementary figures are available with the online version of this paper.