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Published on: October 11, 2018
Clostridium perfringens-induced liver abscess with severe haemolysis
Tomotaka Takanosu1, Yoshimitsu Izawa2, Chikara Yonekawa2
1Emergency Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan r1631tt@jichi.ac.jp.
Abstract:
Clostridium perfringens is notorious for causing skin and soft tissue infections and food poisoning. Rarely, C. perfringens infections are associated with severe haemolysis, with a mortality rate of >80%. A previously healthy man in his 70s who presented with fever as his chief symptom was promptly admitted to a regional core hospital. Over the next 3 hours, shock and multiple organ failure ensued, leading to referral to our hospital for intensive care. We suspected a liver abscess caused by C. perfringens infection with haemolysis, findings of severe haemolysis and a liver mass with gas production that appeared within a few hours. Though surgical drainage was contemplated, low blood pressure resulted in death within 3 hours of arrival at our hospital. The next day, a blood culture confirmed C. perfringens, proving the diagnosis. Improving patient outcomes requires increased awareness of the disease and early detection.
Insights
Clostridium perfringens can cause rare, fatal infections with severe hemolysis and organ failure. Early detection of this aggressive bacterial infection is crucial for improving patient outcomes.
Area of Science:
- Microbiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Clostridium perfringens is a known cause of skin/soft tissue infections and food poisoning.
- Rarely, C. perfringens infections are associated with severe hemolysis and high mortality (>80%).
Observation:
- A previously healthy elderly male presented with fever, rapidly progressing to shock and multiple organ failure within hours.
- Imaging revealed a liver abscess with gas production, indicative of C. perfringens infection.
- Severe hemolysis was a prominent clinical feature.
Findings:
- The patient's rapid deterioration and clinical presentation suggested C. perfringens-induced liver abscess with hemolysis.
- Despite intensive care referral, the patient died within 3 hours of arrival due to refractory shock.
- Blood culture confirmed C. perfringens, validating the suspected diagnosis.
Implications:
- This case highlights the potential for aggressive and rapidly fatal C. perfringens infections, even in previously healthy individuals.
- Increased clinical awareness and prompt diagnostic evaluation are essential for early detection.
- Timely recognition and management may improve outcomes in severe C. perfringens infections.
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