The Journal of Medical Microbiology, Vol 13, Issue 3 445-450, Copyright © 1980 by Society for General Microbiology
Scanning electronmicroscopy of the jejunum in enteritis necroticans
P. D. Walker, T. G. Murrell and L. K. Nagy
Intestinal tissue resected at laparotomy from patients in Papua New Guinea
at various clinical stages of enteritis necroticans, locally known as
pig-bel, has been examined under the scanning electronmicroscope. Evidence
obtained from parallel studies of experimental infection in pigs is
presented. Progressive destruction of the intestinal mucosa was seen during
the course of the disease in man. Numerous filamentous rods morphologically
consistent with the appearance of Clostridium perfringens type C, were seen
to be attached the affected areas of gut and were associated with the
necrotic tissue. The mechanism of pathogenicity includes a stage of
attachment to the surfaces of jejunal villi, local multiplication, and the
production of beta toxin which may be protected from tryptic digestion by
the inadequacy of pancreatic protease production in susceptible subjects
and by the ingestion of a trypsin inhibitor. The association of the
condition with pork feasting is discussed.
