title: Hemophagocytic syndrome associated with clostridial infection in a pancreatic carcinoma patient.
abstract: This report describes the autopsy case of a 71-year-old man presenting with clostridial infection and hemophagocytic syndrome (HS). The patient underwent pancreatoduodenectomy for a pancreatic tumor, and a histological examination revealed an invasive ductal adenocarcinoma. Multiple peritoneal metastases were noted when laparotomy was performed because of postoperative ileus 2 months after the initial operation. Then, acutely progressive anemia associated with fever developed in the patient before death. The autopsy revealed advanced cancer dissemination and HS. In addition, systemic spread of clostridium, confirmed by the polymerase chain reaction method, had resulted in generalized bleb formation. The clostridial infection appeared to be responsible for the HS. This case indicates that HS may occur as a result of clostridial infection.
authors.affiliation: Department of Pathology, Saitama Cancer Center, 818 Komuro, Ina-machi, Saitama 362-0806, Japan. kchinen@kyorin-u.ac.jp
authors.forename: Katsuya
authors.initials: K
authors.lastname: Chinen
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohkura
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsubara
authors.forename: Eiju
authors.initials: E
authors.lastname: Tsuchiya
mesh_terms: D000368:Aged; D001427:Bacterial Toxins / Q000235:genetics / Q000302:isolation & purification; D002135:Calcium-Binding Proteins / Q000235:genetics / Q000302:isolation & purification; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000556:secondary* / Q000601:surgery; D003015:Clostridium Infections / Q000150:complications / Q000473:pathology*; D003016:Clostridium perfringens / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D004269:DNA, Bacterial / Q000032:analysis; D017809:Fatal Outcome; D015616:Histiocytosis, Non-Langerhans-Cell / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D016133:Polymerase Chain Reaction; D010738:Type C Phospholipases / Q000235:genetics / Q000302:isolation & purification
chemical_list: D001427:Bacterial Toxins; D002135:Calcium-Binding Proteins; D004269:DNA, Bacterial; D010738:Type C Phospholipases; C040649:alpha toxin, Clostridium perfringens