Ohtani Shoichiro, Watanabe Naomi, Kawata Masashi, Harada Kimiko, Himei Masahiro, Murakami Kazuharu
Department of Surgery, Tamashima Central Hospital, Kurashiki, Okayama 713-8122, Japan.
Acta Med Okayama. 2006 Dec;60(6):357-60. doi: 10.18926/AMO/30725.
Clostridium perfringens infection is a very rare cause of massive intravascular hemolysis, but it should always be kept in mind, since only early treatment can rescue patients from an otherwise rapidly fatal outcome. We report a case of a 78-year-old diabetic male who was admitted complaining of general fatigue, dark red urine, and vomiting. His blood revealed massive hemolysis. Computer tomography demonstrated huge liver abscess in the right lobe of the liver. About 1 h after admission, he suddenly fell into a critical condition. He died 3 h after admission in spite of intensive care and resuscitation. Clostridium perfringens was detected from the blood taken before death and from liver abscess by biopsy after death. We concluded that this patient died of acute massive intravascular hemolysis in septicemia caused by Clostridium perfringens infection.
产气荚膜梭菌感染是大规模血管内溶血非常罕见的病因,但应始终牢记,因为只有早期治疗才能使患者免于迅速致命的后果。我们报告一例78岁糖尿病男性病例,该患者因全身乏力、暗红色尿液和呕吐入院。其血液检查显示大量溶血。计算机断层扫描显示肝脏右叶有巨大肝脓肿。入院后约1小时,他突然病情危急。尽管进行了重症监护和复苏,他仍在入院后3小时死亡。在死前采集的血液和死后活检的肝脓肿中检测到产气荚膜梭菌。我们得出结论,该患者死于产气荚膜梭菌感染引起的败血症中的急性大规模血管内溶血。