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Case Reports in Emergency Medicine
Volume 2013 (2013), Article ID 948071, 2 pages
http://dx.doi.org/10.1155/2013/948071
Case Report

Acute Hemolysis in the Emergency Department: Think about Clostridium perfringens!

1Department of Emergency Medicine, SAMU/SMUR, Pellegrin Medical University Hospital, 33 000 Bordeaux, France
2Intensive Care Unit, Pellegrin Medical University Hospital, 33 000 Bordeaux, France

Received 10 July 2013; Accepted 14 August 2013

Academic Editors: L. Bojić, W. Mauritz, V. Papadopoulos, and C.-K. Tan

Copyright © 2013 Roustit Cécilia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clostridium perfringens (CP) gives several clinical settings, from an asymptomatic to a massive intravascular hemolysis. We report a case of fatal intravascular hemolysis due to CP septicemia having a hepatic supposed starting point in the emergency department. Like in many cases, the diagnosis was made when patient had already gone into shock and died. The CP septicemia often complicated the course of the digestive or genital pathologies. The alpha toxin can damage the structural integrity of the red cell membrane by means of a phospholipase activity. Nevertheless, a massive intravascular hemolysis arises only rarely in this septicemia, only from 7 to 15% of the cases. The emergency physician has to think about this complication in case of hemoglobinuria and/or signs of hemolysis associated with a septic syndrome. An immediate antibiotic treatment adapted as well as the symptomatic treatment of the spread intravascular coagulation could improve the survival of these patients.