Massive haemolysis due to sepsis caused by Clostridium perfringens secondary to liver abscess. Presentation of two cases with a similar history

Gelonch, Laura Martí; Agüero, Raúl Jiménez; Canas, Nerea Rodríguez; Navascués, Jose María Enriquez

doi:10.1016/j.gastre.2018.11.005

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…When CP becomes vegetative from spores, it begins to grow rapidly. Once the bacteria enter the bloodstream and a large amount of alpha-toxin is released into the blood, red blood cells are hemolyzed and destroyed [6].…”

Section: Discussionmentioning

confidence: 99%

An Autopsy Case of Rapidly Aggravated Clostridium perfringens Septicemia with Colorectal Cancer

Kohya

Murai

Taguchi

et al. 2022

Case Reports in Infectious Diseases

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This report presents a case of a 60-year-old man who was diagnosed with ascending colon cancer with metastases of the lymph nodes and multiple liver metastases. Three days before the introduction of the first chemotherapy, he visited our hospital due to high fever. The blood test revealed an increase in the inflammatory response, hepatobiliary enzyme level, lactate dehydrogenase (LDH) level, and renal function deterioration. Contrast-enhanced computed tomography (CT) showed a rapid progression of primary lesion and liver metastatic lesions. Treatment with 5-fluorouracil, leucovorin, and oxaliplatin and cetuximab (FOLFOX/Cmab) was initiated, and the patient was admitted to our hospital after the first day of chemotherapy. At midnight, he had chills, red urine, and rapid hypoxemia. The second blood test showed progression of anemia; increased total bilirubin, aspartate aminotransferase, and LDH levels; and decreased platelet and fibrinogen levels. The serum was red wine in color, indicating marked hemolysis. The respiratory condition rapidly deteriorated, and tracheal intubation was performed and transferred into the intensive care unit. However, blood oxygenation did not increase, and the patient died the next morning, 19 h after admission, despite intensive care. Postmortem CT showed intraperitoneal free air and gas retention in the liver tumor and portal vein system. Pathological autopsy revealed perforation in ascending colon cancer, many Gram-positive rods in the perforation site, dissemination of bacteria throughout the body, and diffuse pulmonary edema. Subsequently, blood cultures reported Clostridium perfringens (CP), which is a product of alpha-toxin. CP infection can cause rapid aggravation and sudden death. The physicians should be aware of this highly fatal infection, leading to immediate diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

An Autopsy Case of Rapidly Aggravated Clostridium perfringens Septicemia with Colorectal Cancer

Kohya

Murai

Taguchi

et al. 2022

Case Reports in Infectious Diseases

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“…In the literature, like the present case, there are many MIH cases in which liver abscess was responsible for C. perfringens sepsis. 2,[10][11][12][13][14][15][16][17][18][19][20][21][22] As a cause of MIH, infections of the hepatobiliary system are more common than those of any other organs. [23][24][25][26] This can be explained by the anatomical relationship between the hepatobiliary system and the digestive tract where C. perfringens inhabits as a commensal flora.…”

Section: Discussionmentioning

confidence: 99%

“…First, as shown in the present case, MIH is raised as the most important cause of CPRSD to be discussed. 9,[15][16][17][18][19][20][21][22]32 MIH occurs as a complication of C. perfringens sepsis and is frequently associated with severe anemia, acute renal failure, and DIC. 32 MIH has classically been reported in cases of post-abortion and postpartum infections, and gas gangrene.…”

Section: Discussionmentioning

confidence: 99%

Sudden death caused by Clostridium perfringens sepsis presenting as massive intravascular hemolysis

Chinen¹

2020

Autops. Case Rep.

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“…2 In the reported case, seeding to the liver may have been from colonic diverticular disease or from chronic cholecystitis with cholelithiasis. Although studies have shown that C. perfringens sepsis may arise from hepatic abscesses [17][18][19][20][21] this is rare, with a 10-year study of liver abscesses detecting C. perfringens in only 1 of 79 cultures. 22 Pyogenic abscesses are space-occupying lesions within the liver parenchyma filled with pus that are associated with a high morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…In the reported case, seeding to the liver may have been from colonic diverticular disease or from chronic cholecystitis with cholelithiasis. Although studies have shown that C. perfringens sepsis may arise from hepatic abscesses 17–21 this is rare, with a 10-year study of liver abscesses detecting C. perfringens in only 1 of 79 cultures 22 …”

Section: Discussionmentioning

confidence: 99%

Unexpected Death Associated With Clostridial Sepsis

Olds

Gilbert²,

Byard

2020

Am J Forensic Med Pathol

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An 85-year-old woman with a history of breast carcinoma presented to hospital after gradual onset of abdominal pain with hypotension, jaundice, and massive intravascular hemolysis. This was caused by Clostridium perfringens septicemia originating from a liver abscess. Clostridium perfringens septicemia is a rare infection that has a high mortality rate, given that it is frequently unable to be diagnosed until postmortem examination. The source of the pathogen is usually intra-abdominal. Hepatic abscesses, although an uncommon source of primary clostridial infection, should be considered in such cases.

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Massive haemolysis due to sepsis caused by Clostridium perfringens secondary to liver abscess. Presentation of two cases with a similar history

Cited by 5 publications

References 4 publications

An Autopsy Case of Rapidly Aggravated Clostridium perfringens Septicemia with Colorectal Cancer

An Autopsy Case of Rapidly Aggravated Clostridium perfringens Septicemia with Colorectal Cancer

Sudden death caused by Clostridium perfringens sepsis presenting as massive intravascular hemolysis

Unexpected Death Associated With Clostridial Sepsis

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