Acute Hemolysis in the Emergency Department: Think about Clostridium perfringens!

• Main Authors: Roustit Cécilia, Vallé Baptiste, Clouzeau Benjamin, Heydel Virginie, Valdenaire Guillaume, Revel Philippe, Biais Matthieu
• Format: Article
• Language: English
• Published: Hindawi Limited 2013-01-01
• Series: Case Reports in Emergency Medicine
• Online Access: http://dx.doi.org/10.1155/2013/948071

Clostridium perfringens (CP) gives several clinical settings, from an asymptomatic to a massive intravascular hemolysis. We report a case of fatal intravascular hemolysis due to CP septicemia having a hepatic supposed starting point in the emergency department. Like in many cases, the diagnosis was made when patient had already gone into shock and died. The CP septicemia often complicated the course of the digestive or genital pathologies. The alpha toxin can damage the structural integrity of the red cell membrane by means of a phospholipase activity. Nevertheless, a massive intravascular hemolysis arises only rarely in this septicemia, only from 7 to 15% of the cases. The emergency physician has to think about this complication in case of hemoglobinuria and/or signs of hemolysis associated with a septic syndrome. An immediate antibiotic treatment adapted as well as the symptomatic treatment of the spread intravascular coagulation could improve the survival of these patients.