Spontaneous Non-Traumatic &lt;i&gt;Clostridium perfringens&lt;/i&gt; Sepsis

Hifumi, Toru

doi:10.7883/yoken.jjid.2019.382

Cited by 8 publications

(9 citation statements)

References 42 publications

(42 reference statements)

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“…Without early detection, source control, and antibiotics administration, the course of C. Perfringens septicemia can be rapidly fatal. 1,3,4 We present a case of an unfortunate 50 years old man who was found to have C. Perfringens septicemia early after he died from massive hemolysis and highlight the importance of early consideration of massive hemolysis as part of the differential diagnosis when faced with a critically ill patient presenting with a remarkably black-colored urine and mild methemoglobinemia.…”

Section: Introductionmentioning

confidence: 99%

“…Without early detection, source control, and antibiotics administration, the course of C. Perfringens septicemia can be rapidly fatal. 1,3,4…”

Section: Introductionmentioning

confidence: 99%

“…There are 5 biotypes of C. Perfringens, based on the type of toxin that is produced: type A, B, C, D, and E. 2 Alpha toxin, which is produced by all C. Perfringens types, is responsible for gas gangrene and myonecrosis in infected tissues; this toxin also possesses hemolytic activity by functioning as an enzyme that splits lecithin into phosphocholine and diglyceride, leading to the development of spherocytosis and interference with the functional integrity of the red blood cell (RBC) membrane and resulting in anemia, jaundice, and in rare cases, massive hemolysis. 3,4 This causes impairment in the oxygen transport function of the red blood cell (RBC), and subsequent death from tissue hypoxia. 5 Massive intravascular hemolysis is a rare but described complication of C. Perfringens septicemia.…”

Section: Introductionmentioning

confidence: 99%

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Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens

Koubaissi

Assaad

Itani

et al. 2020

Clin Med Insights Case Rep

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Clostridium Perfringens is an anaerobic gram-positive bacillus able to produce different types of toxins and can cause septicemia. The mechanism is through translocation from a previously colonized gastrointestinal or genital tract. Massive intravascular hemolysis induced by this bacterium is a rare presentation reported in only 7% to 15% of cases of Clostridium Perfringens bacteremia with a mortality rate reaching 90%.We present the case of a middle-aged man with metastatic melanoma having black-colored urine as the first sign of massive hemolysis along with mild methemoglobinemia. Despite timely management, the patient progressed into septic shock with severe hypoxia and passed away. Postmortem, blood cultures grew clostridium perfringens. Black-colored urine and blood samples, sepsis-induced mild methemoglobinemia and acute massive hemolysis should raise concern for Clostridium Perfringens sepsis in the appropriate clinical settings.

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Section: Introductionmentioning

confidence: 99%

“…Without early detection, source control, and antibiotics administration, the course of C. Perfringens septicemia can be rapidly fatal. 1,3,4…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens

Koubaissi

Assaad

Itani

et al. 2020

Clin Med Insights Case Rep

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“…The disease is a lifethreatening necrotizing soft tissue infection that leads to myonecrosis, shock, multiple organ failure, and death of patients (Bryant, 2003;Titball, 2005). C. perfringens sepsis often develops extremely rapidly, accompanied by intravascular hemolysis and metabolic acidosis and has a high mortality rate (Hifumi, 2020). The only current therapeutic measures are hyperbaric oxygen therapy and use of antibiotics, but these treatments are not sufficient to prevent disease progression in some patients (Stephens, 1996;Bryant and Stevens, 2010).…”

Section: Introductionmentioning

confidence: 99%

Toll-Like Receptor 4 Protects Against Clostridium perfringens Infection in Mice

Takehara

Kobayashi

Nagahama

2021

Front. Cell. Infect. Microbiol.

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Toll-like receptor 4 (TLR4) has been reported to protect against Gram-negative bacteria by acting as a pathogen recognition receptor that senses mainly lipopolysaccharide (LPS) from Gram-negative bacteria. However, the role of TLR4 in Gram-positive bacterial infection is less well understood. Clostridium perfringens type A is a Gram-positive bacterium that causes gas gangrene characterized by severe myonecrosis. It was previously demonstrated that C. perfringens θ-toxin is a TLR4 agonist, but the role of TLR4 in C. perfringens infection is unclear. Here, TLR4-defective C3H/HeJ mice infected with C. perfringens showed a remarkable decrease in survival rate, an increase in viable bacterial counts, and accelerated destruction of myofibrils at the infection site compared with wild-type C3H/HeN mice. These results demonstrate that TLR4 plays an important role in the elimination of C. perfringens. Remarkable increases in levels of inflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and granulocyte colony-stimulating factor (G-CSF), were observed in C. perfringens-infected C3H/HeN mice, whereas the increases were limited in C3H/HeJ mice. Generally, increased G-CSF accelerates granulopoiesis in the bone marrow and the spleen to exacerbate neutrophil production, resulting in elimination of bacteria. The number of neutrophils in the spleen was increased in C. perfringens-infected C3H/HeN mice compared with non-infected mice, while the increase was lower in C. perfringens-infected C3H/HeJ mice. Furthermore, DNA microarray analysis revealed that the mutation in TLR4 partially affects host gene expression during C. perfringens infection. Together, our results illustrate that TLR4 is crucial for the innate ability to eliminate C. perfringens.

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“…Previous studies have shown the role of anaerobic BC in the neonatal population. Although strict anaerobic bacteremia is extremely rare in neonates, omitting an anaerobic bottle decrease the identification of clinically significant bacteria because it allows detection of anaerobic bacteria and identify facultative aerobic gram-negative bacilli [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Role of Clostridium Perfringens in Neonatal Necrotizing Enterocolitis and the Utility of Anaerobic Blood Cultures

C¹,

O²,

E³

et al. 2021

J Pediatr Res Rev Rep

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Introduction: Clostridium perfringens is a gram-positive anaerobic bacillus that causes various clinical diseases, including necrotizing enterocolitis in newborns. The progression could be fulminant and lethal. Presentation of the cases: We report 3 cases of necrotizing enterocolitis due to C. perfringens from 2 high-complexity public centers in Chile. Conclusion: Strong clinical suspicion combined with early microbiological identification may modify patient evolution. Anaerobic blood cultures have become a fundamental diagnostic method; therefore, having this tool in neonatal units would be useful

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Spontaneous Non-Traumatic <i>Clostridium perfringens</i> Sepsis

Cited by 8 publications

References 42 publications

Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens

Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens

Toll-Like Receptor 4 Protects Against Clostridium perfringens Infection in Mice

Role of Clostridium Perfringens in Neonatal Necrotizing Enterocolitis and the Utility of Anaerobic Blood Cultures

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