[Massive haemolysis: a rare manifestation of sepsis due to Clostridium perfringens].
A 59-year-old man was admitted to the hospital to be operated on for carcinoma of the pancreas. During the operation, it turned out that resection ofthe tumour was not possible. Therefore, a double bypass was created for palliation: hepaticojejunostomy and duodenojejunostomy. The postoperative course was complicated by a fulminant sepsis accompanied by massive intravascular haemolysis. This is a rare and often fatal complication of a Clostridium perfringens sepsis. The patient was given antibiotics and multiple blood transfusions, but his haemoglobin remained low and despite the administration of large amounts of fluid, high doses ofinotropic agents and corticosteroids, it was not possible to achieve an adequate circulation. The patient died within 40 hours after admission to Intensive Care. Severe intravascular haemolysis with spherocytes in the blood smear must be interpreted as an important indication of a C. perfringens-sepsis.
Leeda
M
M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd Intensive Care Volwassenen. michalleeda@gmail.com
van der Sloot
J A P
JA
D002277:Carcinoma / Q000601:surgery; D003015:Clostridium Infections / Q000150:complications*; D003016:Clostridium perfringens; D017809:Fatal Outcome; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications