Type A fulminant Clostridium perfringens sepsis indicated RBC/Hb discrepancy; a case report

Abstract

Background Clostridium perfringens can cause various infections, including food poisoning, gas gangrene, cellulitis and fasciitis. C. perfringens septicemia is rare, but is a known cause of hemolysis by damaging red blood cell, and often proves rapidly fatal in emergency department (ED) situations. Case presentation A previously healthy 76-year-old man presented to the ED 8 h after onset of acute abdominal pain and diarrhea. Laboratory examination revealed a large discrepancy between the red blood cell count of 1.91 × 10 6 /mm 3 and the hemoglobin level of 10.3 g/dL, suggesting massive intravascular hemolysis. Computed tomography revealed liver abscesses with gas. During ED treatment, the state of the patient rapidly deteriorated and he entered cardiopulmonary arrest. Blood cultures finally identified C. perfringens . Conclusion Intravascular hemolysis and red blood cell (RBC) / hemoglobin (Hb) discrepancy in the presence of infection should prompt ED physicians to consider C. perfringens septicemia and to act quickly to provide appropriate treatment.

Role of hematological parameters in the diagnosis of influenza virus infection in patients with respiratory tract infection symptoms

“…At present, it is well known that influenza hemagglutinin readily binds to sialic acid receptors on the membranes of red blood cells, causing red blood cells to clump together or agglutinate . Some bacterial infections cause intravascular hemolysis leading to sepsis, which reduces the red blood cell count and may be why bacterial infections cause more significant reduction in red blood cells.…”

Detection and Analysis of Clostridioides difficile Spores in a Hospital Environment

“…In addition to the detection of C. difficile in the direct environment of the patient, studies have also confirmed the presence of other pathogenic species, such as C. perfringens , C. sporogenes , C. innocuum and C. baratii . These are species which are also detected in other medical facilities and which may constitute a significant disease-causing problem related to HAI [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Analysis of the behaviour of hospital personnel was not a direct goal of this study, but it supplements the conducted research analyses.…”

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)

“…次に，この感染症を引き起こす病態であるが，本症例では，胆道系感染が関連していたが，胆道系疾患に対するERCP施行後に感染した症例も見られ，胆道系の炎症が要因の一つとして注目される 12)。ただし，なかには基礎疾患を有さず胃腸炎の症状だけで，目立った手がかりを見出せなかった報告もある 7), 16), 17)。転帰に関しては13例中，11例が死亡しており，やはり救命が難しい病態であることを示している。さらに，死亡例のうち7例が24時間以内に死亡しており，進展が極めて急速であることを物語っている。…”