Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens

Clostridium perfringens causes pyogenic liver abscesses, which are rare but rapidly fatal infections. These abscesses often occur in patients with immunodeficiency due to malignancy, liver cirrhosis, diabetes mellitus, or organ transplantation. The identification of gram-positive bacilli in septice...

Full description

Saved in:
Bibliographic Details
Main Authors: Jiang Guo, Changqing Li, Xuesong Gao
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2022-01-01
Series:Journal of Infection in Developing Countries
Subjects:
Online Access:https://jidc.org/index.php/journal/article/view/13756
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850036874490413056
author Jiang Guo
Changqing Li
Xuesong Gao
author_facet Jiang Guo
Changqing Li
Xuesong Gao
author_sort Jiang Guo
collection DOAJ
description Clostridium perfringens causes pyogenic liver abscesses, which are rare but rapidly fatal infections. These abscesses often occur in patients with immunodeficiency due to malignancy, liver cirrhosis, diabetes mellitus, or organ transplantation. The identification of gram-positive bacilli in septicemia, the presence of gas-forming liver damage and intravascular hemolysis are manifestations of Clostridium perfringens infection. Clostridioides toxin A hydrolyzes phospholipids in erythrocyte membranes, causing spherocytosis and subsequent intravascular hemolysis, resulting in rapid deterioration and a high mortality rate. A 62-year-old man with recurrent hepatocellular carcinoma complained of a high fever and abdominal pain one day after microwave ablation. Abdominal computed tomography revealed gas-containing lesions in the liver. His condition was complicated with massive hemolysis. Laboratory examinations revealed low hemoglobin, high serum lactate dehydrogenase, and elevated indirect bilirubin levels, suggesting massive intravascular hemolysis. Although aggressive treatment was applied, he died within 16 hours after onset of the infection. After the patient died, a blood culture indicated Clostridium perfringens positivity. Clostridium perfringens-induced septicemia with massive hemolysis is rare but rapidly leads to a severe prognosis. It is important to identify Clostridium perfringens infection early and initiate effective treatment, especially abscess aspiration, which should be performed as soon as possible.
format Article
id doaj-art-d4044dc5eff546e586656f91d70921d5
institution DOAJ
issn 1972-2680
language English
publishDate 2022-01-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-d4044dc5eff546e586656f91d70921d52025-08-20T02:57:01ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-01-01160110.3855/jidc.13756Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringensJiang Guo0Changqing Li1Xuesong Gao2Department of Interventional Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of General Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China Clostridium perfringens causes pyogenic liver abscesses, which are rare but rapidly fatal infections. These abscesses often occur in patients with immunodeficiency due to malignancy, liver cirrhosis, diabetes mellitus, or organ transplantation. The identification of gram-positive bacilli in septicemia, the presence of gas-forming liver damage and intravascular hemolysis are manifestations of Clostridium perfringens infection. Clostridioides toxin A hydrolyzes phospholipids in erythrocyte membranes, causing spherocytosis and subsequent intravascular hemolysis, resulting in rapid deterioration and a high mortality rate. A 62-year-old man with recurrent hepatocellular carcinoma complained of a high fever and abdominal pain one day after microwave ablation. Abdominal computed tomography revealed gas-containing lesions in the liver. His condition was complicated with massive hemolysis. Laboratory examinations revealed low hemoglobin, high serum lactate dehydrogenase, and elevated indirect bilirubin levels, suggesting massive intravascular hemolysis. Although aggressive treatment was applied, he died within 16 hours after onset of the infection. After the patient died, a blood culture indicated Clostridium perfringens positivity. Clostridium perfringens-induced septicemia with massive hemolysis is rare but rapidly leads to a severe prognosis. It is important to identify Clostridium perfringens infection early and initiate effective treatment, especially abscess aspiration, which should be performed as soon as possible. https://jidc.org/index.php/journal/article/view/13756Liver infectionClostridium perfringenshemolysishepatocellular carcinomamicrowave ablation
spellingShingle Jiang Guo
Changqing Li
Xuesong Gao
Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
Journal of Infection in Developing Countries
Liver infection
Clostridium perfringens
hemolysis
hepatocellular carcinoma
microwave ablation
title Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
title_full Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
title_fullStr Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
title_full_unstemmed Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
title_short Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens
title_sort liver abscess after microwave ablation of hepatocellular carcinoma caused by clostridium perfringens
topic Liver infection
Clostridium perfringens
hemolysis
hepatocellular carcinoma
microwave ablation
url https://jidc.org/index.php/journal/article/view/13756
work_keys_str_mv AT jiangguo liverabscessaftermicrowaveablationofhepatocellularcarcinomacausedbyclostridiumperfringens
AT changqingli liverabscessaftermicrowaveablationofhepatocellularcarcinomacausedbyclostridiumperfringens
AT xuesonggao liverabscessaftermicrowaveablationofhepatocellularcarcinomacausedbyclostridiumperfringens