An Autopsy Case of Fulminant Systemic Infection of Clostridium perfringens With a Diverse Role of Toxins in a Healthy Patient.

IF 0.7 Q4 PATHOLOGY Case Reports in Pathology Pub Date : 2024-09-14 eCollection Date: 2024-01-01 DOI:10.1155/2024/9213132
Ayano Osamura, Hiromi Onizuka, Kenta Masui, Kumiko Murakami, Tomoko Yamamoto, Yoji Nagashima, Munekazu Takeda, Atsushi Kurata
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Abstract

We herein report an autopsy case of a fulminant Clostridium perfringens (C. perfringens or Welch bacilli) infection in a healthy adult. A 72-year-old, immunocompetent man visited the emergency department with lower back pain, and blood test revealed hemolytic attack. His condition rapidly worsened with severe acidosis and anemia, and he died despite symptomatic treatment. An autopsy examination demonstrated an abscess with necrosis and air spaces in the right lobe of his liver. Numerous Gram-positive bacilli were seen in the liver and bone marrow, and C. perfringens was identified in culture of the antemortem blood sample. Of note, a mucosal epithelium of the ileum showed loss of tight junctions (claudin 4), suggesting the involvement of C. perfringens toxins with its systemic spreading. Welch toxins were suggested to be involved in serious pathological conditions such as hemolytic anemia and systemic infections, and it is necessary to raise Welch infection as one of the differential diagnoses for fulminant systemic infections even in healthy individuals.

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健康患者全身感染产气荚膜梭菌并伴有多种毒素的尸检病例
我们在此报告了一例健康成年人暴发性产气荚膜梭菌(C. perfringens 或韦氏杆菌)感染的尸检病例。一名 72 岁、免疫功能正常的男子因下腰疼痛到急诊科就诊,血液化验显示为溶血性发作。他的病情迅速恶化,出现严重酸中毒和贫血,虽经对症治疗仍不治身亡。尸检显示,他的肝脏右叶有脓肿、坏死和气隙。肝脏和骨髓中可见大量革兰氏阳性杆菌,尸检血样培养发现了产气荚膜杆菌。值得注意的是,回肠粘膜上皮细胞显示出紧密连接(claudin 4)的缺失,表明C. perfringens毒素参与了其全身扩散。韦尔奇毒素被认为与溶血性贫血和全身感染等严重病症有关,因此有必要将韦尔奇感染作为即使是健康人也会发生的急性全身感染的鉴别诊断之一。
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审稿时长
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