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[A case of invasive Clostridium perfringens infection complicated intravascular hemolysis]
Junko Fukuhara1, Masakazu Kouda, Shoko Homma
1First Division of Clinical Laboratories, Tokyo Metropolitan Police Hospital.
Abstract:
We experience a case of a 83-year-old male who was admitted complaining of chills, cramp, high fever and respiratory distress. His blood revealed marked hemolysis. Gram positive Rods was observed in the hemoliesed blood taken on admission. About 2 hours after admission, he suddenly fell into a critical condition. He died about 6 hours after admission in spite of resuscitation. Clostridium perfringens was detected from the blood and liver obtained by autopsy. We suspected that he died of acute intravascular hemolysis caused by alpha-toxin produced by C. perfringens. In conclusion, for a patient who has a high fever with strong hemolysis such as our case, C. perfringens infection should be considered.
Insights
A severe Clostridium perfringens infection caused rapid, fatal hemolysis in an elderly male. Prompt consideration of this pathogen is crucial for patients presenting with high fever and significant hemolysis.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hematology
Background:
- Clostridium perfringens is an anaerobic, Gram-positive bacterium known for producing potent toxins.
- Alpha-toxin (phospholipase C) is a key virulence factor associated with C. perfringens, capable of causing significant tissue damage and hemolysis.
- Severe hemolysis can lead to rapid organ dysfunction and mortality.
Observation:
- An 83-year-old male presented with chills, cramps, high fever, and respiratory distress.
- Blood analysis revealed marked hemolysis with the presence of Gram-positive rods.
- The patient's condition rapidly deteriorated, leading to death within 6 hours of admission despite resuscitation efforts.
Findings:
- Autopsy results confirmed the presence of Clostridium perfringens in blood and liver samples.
- The clinical presentation and laboratory findings strongly suggest acute intravascular hemolysis as the cause of death.
- The hemolysis was attributed to the alpha-toxin produced by C. perfringens.
Implications:
- This case highlights the potential for C. perfringens to cause fulminant and fatal hemolysis.
- Clinicians should consider C. perfringens infection in patients with high fever and severe hemolysis.
- Early diagnosis and appropriate management of C. perfringens infections are critical to improve patient outcomes.