Some diabetics and others with weakened immune systems may do well to steer clear of chitterlings, a dish consisting of boiled pig intestines that is served up as traditional holiday fare in the Southern US. A 12-year-old boy with poorly controlled diabetes became seriously ill after eating the food in three separate Christmas dinners.

The child was hospitalized with enteritis necroticans, a potentially life-threatening intestinal infection that is rare in America and causes severe stomach pain, vomiting of blood and low blood pressure. The boy eventually had to have surgery to restore his intestinal function. The culprit turned out to be a chitterlings-contaminating bacterium known as Clostridium perfringens type C, which produces a toxin that is lethal to tissue in the digestive tract. Even cooking the chitterlings, however, may not rid them of bacteria.

More common in developing countries, enteritis necroticans can occur in children who eat large amounts of pork or in those who consume large meals after a period of starvation. Other factors that can contribute to the illness are protein malnutrition, and the consumption of sweet potatoes, which can interfere with the breakdown of the bacterial toxin in the intestines.

The New England Journal of Medicine April 27, 2000;342:1250-1253