title: Fatal Clostridium perfringens sepsis due to emphysematous gastritis and literature review.
abstract: A 76-year-old female patient was admitted to the Level I Emergency Department of University of Szeged with severe abdominal pain and vomiting. The clinical assessment with laboratory tests and radiological investigations confirmed severe sepsis associated with intravascular hemolysis and multiorgan failure and acute pancreatitis. On the abdominal CT, besides of other abnormalities, the presence of gas bubbles in the stomach, small intestines and liver were seen. The gastric alterations pointed to emphysematous gastritis. Despite of the medical treatment, the patient's condition quickly deteriorated and eight hours after admission the patient died. The autopsy evaluation revealed systemic infection of abdominal origin caused by gas-producing Gram-positive bacteria, and the post-mortem microbiological cultures confirmed the presence of Cloctridium perfringens in many abdominal organs. Emphysematous gastritis seemed to be the primary infectious focus.
authors.affiliation: Department of Clinical Microbiology, University of Szeged, Szeged, Hungary. Electronic address: sarvari.karoly.peter@med.u-szeged.hu.
authors.forename: Karoly Peter
authors.initials: KP
authors.lastname: Sarvari
authors.affiliation: Department of Pathology, University of Szeged, Szeged, Hungary.
authors.forename: Bela
authors.initials: B
authors.lastname: Vasas
authors.affiliation: DIAGNOSCAN Ltd. Hungary, Szeged, Hungary.
authors.forename: Ildiko
authors.initials: I
authors.lastname: Kiss
authors.affiliation: Department of Clinical Microbiology, University of Szeged, Szeged, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lazar
authors.affiliation: DIAGNOSCAN Ltd. Hungary, Szeged, Hungary.
authors.forename: Istvan
authors.initials: I
authors.lastname: Horvath
authors.affiliation: Department of Emergency Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Marianna
authors.initials: M
authors.lastname: Simon
authors.affiliation: Department of Emergency Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Peto
authors.affiliation: Department of Clinical Microbiology, University of Szeged, Szeged, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Urban
mesh_terms: D000368:Aged; D003016:Clostridium perfringens / Q000254:growth & development / Q000302:isolation & purification / Q000472:pathogenicity*; D004646:Emphysema / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005738:Gas Gangrene / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D059413:Intraabdominal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
keywords: CT-scan; Clostridium perfringens; Emphysematous gastritis; Sepsis