Summary
Massive hemolysis is a rare, usually fatal complication ofClostridium 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 ofC. 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.
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Hübl, W., Mostbeck, B., Hartleb, H. et al. Investigation of the pathogenesis of massive hemolysis in a case ofClostridium perfringens septicemia. Ann Hematol 67, 145–147 (1993). https://doi.org/10.1007/BF01701741
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DOI: https://doi.org/10.1007/BF01701741