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Case Reports in Medicine
Volume 2018, Article ID 4278904, 4 pages
https://doi.org/10.1155/2018/4278904
Case Report

Clostridium perfringens Septicemia and a Bleeding Ulcer of a Jejunal Interposition: A Case Report and Short Review of the Literature

1Department of General, Visceral, Vascular and Thoracic Surgery, Clinical Center Frankfurt Höchst, Frankfurt, Germany
2Department of Trauma and Orthopedic Surgery, BG Trauma Center, Frankfurt, Germany
3Department of Anesthesiology and Emergency Medicine, Clinical Center Frankfurt Höchst, Frankfurt, Germany
4Department of Pathology, Clinical Center Frankfurt Höchst, Frankfurt, Germany
5Institute of Radiology, Clinical Center Frankfurt Höchst, Frankfurt, Germany

Correspondence should be addressed to F. Bormann; ed.trufknarfmukinilk@nnamrob.naibaf

Received 2 October 2017; Accepted 21 December 2017; Published 22 January 2018

Academic Editor: Bruno Megarbane

Copyright © 2018 W. Wild 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

Introduction. We report a case of Clostridium perfringens septicemia in a patient presenting with a bleeding ulcer of a jejunal interposition. Case Presentation. An 81-year-old female patient was acutely admitted to our hospital due to hematemesis and melena. She had a history of metastatic gastrointestinal stromal tumor, for which she was receiving second line treatment with sunitinib. She had also undergone a Merendino procedure 4 years prior to presentation. The patient underwent emergency gastroscopy, which revealed a bleeding ulcer in the jejunal interposition. Despite initial endoscopic control of the bleeding and transfusion of blood products, the hemoglobin level continued to drop, and the patient was treated for an assumed hemolytic transfusion reaction. The patient died 3 days following admission, and the results of blood cultures later confirmed a Clostridium perfringens septicemia. The postmortem examination revealed a diffuse spread of Clostridium perfringens to multiple organs. Conclusion. This case is a reminder of the importance of considering septicemia, particularly in association with Clostridium perfringens, as a potential cause of hemolysis. It also demonstrates the extent of organ involvement in a case of diffuse clostridial myonecrosis.