Elejalde Guerra José Ignacio, Elcuaz Viscarret Rosario, Almaraz Ruiz De Eguilaz María José, Melendez Gracia Alberto
Servicio de Urgencias, Hospital de Navarra, Pamplona, España.
Arch Esp Urol. 2002 May;55(4):446-8.
To present a case of fulminant sepsis caused by Clostridium perfringens of urological origin.
An 81-year-old diabetic female (the only factor of immunodepression) presented complicated renal colic two days later with fulminant and fatal sepsis caused by Clostridium perfringens with signs of disseminated intravascular coagulation.
The patient died one hour after the presentation of disseminated intravascular coagulation despite attempts to resuscitate the patient in the emergency department. Due to the fulminant course of the condition, it was not possible to demonstrate the presence of massive intravascular hemolysis characteristic of these conditions. Blood cultures obtained immediately after the patient died were positive for Clostridium perfringens.
Sepsis is a possible complication of infection from Clostridium perfringens. It is more frequent in immune-depressed patients and carries a high mortality despite medical and surgical treatment. Although it is not the most frequent, the genitourinary tract is a known portal of entry that should not be forgotten as in the case described herein.
报告一例由泌尿源性产气荚膜梭菌引起的暴发性脓毒症病例。
一名81岁的糖尿病女性（唯一的免疫抑制因素）在两天后出现复杂的肾绞痛，随后因产气荚膜梭菌引起暴发性致命脓毒症，并伴有弥散性血管内凝血迹象。
尽管在急诊科对患者进行了复苏尝试，但患者在出现弥散性血管内凝血一小时后死亡。由于病情发展迅猛，无法证实这些病症所特有的大量血管内溶血的存在。患者死亡后立即采集的血培养结果显示产气荚膜梭菌呈阳性。
脓毒症是产气荚膜梭菌感染可能出现的并发症。在免疫抑制患者中更为常见，尽管进行了药物和手术治疗，但其死亡率仍然很高。虽然泌尿生殖道并非最常见的感染途径，但如本文所述病例一样，它是一个不应被忽视的已知感染入口。
