In New Guinea, where people generally have low-protein diets apart from tribal feasts, a number of factors—diet and endemic helminth infections among them—compound to result in pig-bel.
Laboratory findings of infants presenting with NEC often include anemia, thrombocytopenia, evidence of disseminated intravascular coagulopathy (DIC), and in 20 percent of cases a positive blood culture.
[16] All the factors collectively causing CNE are generally only present in the hinterlands of New Guinea and parts of Africa, Latin America, and Asia.
CNE was also diagnosed in post-World War II Germany, where it was known as Darmbrand or "bowel fire," and reached epidemic proportions.
The causative agents of these CNE cases have since been described as Type C isolates of C. perfringens, which possessed genes for β-toxins and enterotoxins.
[15] About half of seriously ill patients require surgery for perforation, persistent intestinal obstruction, or failure to respond to the antibiotics.
The use of oral aminoglycosides is not recommended because it can result in the development of resistant bacterial strains, and has not been shown to be more beneficial than standard care.