Fatal fulminant infection with Clostridium perfringens

Abstract

The patient was a 60-year-old man treated with an oral hypoglycemic agent for diabetes. He visited a local physician because of epigastralgia, which appeared 2 days earlier. Although a pain killer was prescribed, it was not effective, and he was examined during an emergency visit at our hospital. On admission, hematuria was observed. Blood chemistry showed prominent hemolysis, and anemia, disorder of blood coagulation, and elevated T-Bil, AST, and LDH levels were found. Abdominal computed tomography revealed a gas-forming liver abscess. Despite intensive treatment with infusion, blood transfusion, antibiotic therapy and surgical drainage, he died because of multiple organ failure due to rapid hemolysis 12 h after admission. Clostridium perfringens was observed in his blood and ascites culture. Prominent hemolysis may be induced followed by Clostridium perfringens septicemia. Early medical examination is indispensable because of a high mortality rate when hemolysis develops. For early treatment, the detection of large gram-positive bacilli by the gram staining of a specimen from a patient should contribute to an early treatment and the improvement of survival rate.