Fatal Clostridium perfringens septicemia suggested by postmortem computed tomography: A medico-legal autopsy case report

Unexpected Death Associated With Clostridial Sepsis

“…2 In a review of 40 cases of C. perfringens septicemia, the median time between admission and death was 8 hours. 16 This was also our experience with death occurring within 4 hours of admission. As in many cases, the diagnosis is not made during life, 12 the autopsy may play a vital role in elucidating terminal mechanisms.…”

“…16 Although postmortem computed tomography was not performed in our case, characteristic features include massive systemic gas distribution and alveolar-like parenchymal gas collections in solid organs after only short postmortem intervals. 16 The most common source of clostridial bacteremia is intra-abdominal infection, followed by skin and soft tissue infections (including surgical wounds); rarely, it can derive from lower respiratory tract infection. 2 In the reported case, seeding to the liver may have been from colonic diverticular disease or from chronic cholecystitis with cholelithiasis.…”

Clostridium perfringensによるガス産生性肝膿瘍の1例(A case of gas–forming liver abscess caused by Clostridium perfringens)

“…一方，ガス産生性肝膿瘍の起因菌については Klebsiella pneumoniae の占める割合がおよそ9割と圧倒的に多く（80.6%～100%），それ以外では， E. coli などが知られているが， C. perfringens によるものは稀である 3)。そのうえ， C. perfringens に伴う炎症は急速に波及して生命を奪うことから，剖検時などに死因調査の視点から報告されることもある 4), 5)。…”

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

“…In these cases, alpha-toxin secreted by C. perfringens is considered to be the main toxin, which is responsible for intravascular hemolysis, disseminated intravascular coagulopathy (DIC) (12,13), and multiple organ failure. Although the number of reported cases with spontaneous C. perfringens sepsis is increasing (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), appropriate treatment strategies have not been established.…”