Investigation of the pathogenesis of massive hemolysis in a case of Clostridium perfringens septicemia.
Massive hemolysis is a rare, usually fatal complication of Clostridium perfringens septicemia. Of all toxins produced by the bacterium, phospholipase C (PLC) is believed to be the most likely cause of hemolysis. An influence of neuraminidase has often been suspected. In the present study, a case of C. perfringens septicemia with acute massive intravascular hemolysis is described. It led to death within 4 h of admission to the hospital. While the course of events was comparable to previously reported cases, we succeeded in gaining deeper insight into the pathogenesis by monitoring serum anti-T titer and quantifying serum PLC activity during the course of the disease. We excluded an effect of neuraminidase by a negative direct antiglobulin test, a negative anti-T lectin test, and a steady serum anti-T titer of 1 in 32. Serum PLC activity, on the other hand, showed a nearly fivefold increase (6.0 to 27.3 U/l), which is consistent with the hypothesized dominant role of this enzyme.
Institute of Clinical Chemistry and Laboratory Medicine, Wilhelminenspital, City of Vienna, Austria.
W
W
Hübl
B
B
Mostbeck
H
H
Hartleb
H
H
Pointner
K
K
Kofler
P M
PM
Bayer
D000368:Aged; D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000209:etiology*; D000957:Antigens, Viral, Tumor / Q000097:blood / Q000652:urine; D016470:Bacteremia / Q000150:complications*; D003015:Clostridium Infections / Q000150:complications*; D003016:Clostridium perfringens; D005260:Female; D006461:Hemolysis / Q000502:physiology; D006801:Humans; D010738:Type C Phospholipases / Q000097:blood / Q000652:urine
D000957:Antigens, Viral, Tumor; D010738:Type C Phospholipases