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Am J Case Rep. 2016 Apr 6;17:219-23.

Clostridium Perfringens Infection in a Febrile Patient with Severe Hemolytic Anemia.

Author information

1
Department of Emergency and Acute Intensive Care Medicine, Aichi Medical University, Nagakute, Japan.
2
Department of Emergency, Nagoya City University, Nagoya, Japan.
3
Department of Emergency and Acute Intensive Care Medicine, Fujita Health University, Toyoake, Japan.

Abstract

BACKGROUND:

Clostridium perfringens (C. perfringens) can cause various infections, including gas gangrene, crepitant cellulitis, and fasciitis. While C. perfringens sepsis is uncommon, it is often rapidly fatal because the alpha toxin of this bacterium induces massive intravascular hemolysis by disrupting red blood cell membranes.

CASE REPORT:

We present the case of a male patient with diabetes who developed a fatal liver abscess with massive intravascular hemolysis and septic shock caused by toxigenic C. perfringens. The peripheral blood smear showed loss of central pallor, with numerous spherocytes. Multiplex PCR only detected expression of the cpa gene, indicating that the pathogen was C. perfringens type A.

CONCLUSIONS:

C. perfringens infection should be considered in a febrile patient who has severe hemolytic anemia with a very low MCV, hemolyzed blood sample, and negative Coombs test. The characteristic peripheral blood smear findings may facilitate rapid diagnosis.

PMID:
27049736
PMCID:
PMC4824343
DOI:
10.12659/ajcr.895721
[Indexed for MEDLINE]
Free PMC Article

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