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CASE REPORT

Clostridium perfringens Liver Abscess Disguised as Biliary Disease: A Report of Two Cases and a Review of the Literature

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Pages 5209-5222 | Received 18 Apr 2023, Accepted 26 Jul 2023, Published online: 11 Aug 2023

References

  • Guo J, Li C, Gao X. Liver abscess after microwave ablation of hepatocellular carcinoma caused by Clostridium perfringens. J Infect Dev Ctries. 2022;16(1):222–225. doi:10.3855/jidc.13756
  • Law ST, Lee MK. A middle-aged lady with a pyogenic liver abscess caused by Clostridium perfringens. World J Hepatol. 2012;4(8):252–255. doi:10.4254/wjh.v4.i8.252
  • Rives C, Chaudhari D, Swenson J, Reddy C, Young M. Clostridium perfringens liver abscess complicated by bacteremia. Endoscopy. 2015;47(1). doi:10.1055/s-0034-1392867
  • Kiu R, Hall LJ. An update on the human and animal enteric pathogen Clostridium perfringens. Emerg Microbes Infect. 2018;7(1):141. doi:10.1038/s41426-018-0144-8
  • Rood JI, Adams V, Lacey J, et al. Expansion of the Clostridium perfringens toxin-based typing scheme. Anaerobe. 2018;53:5–10. doi:10.1016/j.anaerobe.2018.04.011
  • Rechner PM, Agger WA, Mruz K, Cogbill TH. Clinical features of clostridial bacteremia: a review from a rural area. Clin Infect Dis. 2001;33(3):349–353. doi:10.1086/321883
  • Kapoor JR, Monteiro B, Tanoue L, Siegel MD. Massive intravascular hemolysis and a rapidly fatal outcome. Chest. 2007;132(6):2016–2019. doi:10.1378/chest.07-0853
  • Shibazaki S, Yasumoto T, Nakaizumi T. Massive intravascular haemolysis due to Clostridium perfringens. BMJ Case Rep. 2018;2018. doi:10.1136/bcr-2017-223464
  • Liu F, Xue S, Zhang Y, et al. Clostridium perfringens sepsis in three patients with acute leukemia and review of the literature. Int J Hematol. 2021;113(4):508–517. doi:10.1007/s12185-020-03060-z
  • Woittiez NJC, van Prehn J, van Immerseel F, et al. Toxinotype A Clostridium perfringens causing septicaemia with intravascular haemolysis: two cases and review of the literature. Int J Infect Dis. 2022;115:224–228. doi:10.1016/j.ijid.2021.12.331
  • Awad MM, Bryant AE, Stevens DL, Rood JI. Virulence studies on chromosomal alpha-toxin and theta-toxin mutants constructed by allelic exchange provide genetic evidence for the essential role of alpha-toxin in Clostridium perfringens-mediated gas gangrene. Mol Microbiol. 1995;15(2):191–202. doi:10.1111/j.1365-2958.1995.tb02234.x
  • Sarker MR, Carman RJ, McClane BA. Inactivation of the gene (cpe) encoding Clostridium perfringens enterotoxin eliminates the ability of two cpe-positive C. perfringens type A human gastrointestinal disease isolates to affect rabbit ileal loops. Mol Microbiol. 1999;33(5):946–958. doi:10.1046/j.1365-2958.1999.01534.x
  • Stabler S, Titecat M, Duployez C, et al. Clinical relevance of Clostridium bacteremia: an 8-year retrospective study. Anaerobe. 2020;63:102202. doi:10.1016/j.anaerobe.2020.102202
  • Kwon YK, Cheema FA, Maneckshana BT, Rochon C, Sheiner PA. Clostridium paraputrificum septicemia and liver abscess. World J Hepatol. 2018;10(3):388–395. doi:10.4254/wjh.v10.i3.388
  • Ng H, Lam SM, Shum HP, Yan WW. Clostridium perfringens liver abscess with massive haemolysis. Hong Kong Med J. 2010;16(4):310–312.
  • Jha AK, Das A, Chowdhury F, Biswas MR, Prasad SK, Chattopadhyay S. Clinicopathological study and management of liver abscess in a tertiary care center. J Nat Sci Biol Med. 2015;6(1):71–75. doi:10.4103/0976-9668.149091
  • Pérez J. Amoebic Liver Abscess: revisited; 2006.
  • Longworth S, Han J. Pyogenic liver abscess. Clin Liver Dis. 2015;6(2):51–54. doi:10.1002/cld.487
  • Huang CJ, Pitt HA, Lipsett PA, et al. Pyogenic hepatic abscess. Changing trends over 42 years. Ann Surg. 1996;223(5):600–7; discussion 607–9. doi:10.1097/00000658-199605000-00016
  • Kivel RM, Kessler A, Cameron DJ. Liver abscess due to Clostridium perfringens. Ann Intern Med. 1958;49(3):672–679. doi:10.7326/0003-4819-49-3-672
  • Mera CL, Freedman MH. Clostridium liver abscess and massive hemolysis. Unique demise in Fanconi’s aplastic anemia. Clin Pediatr. 1984;23(2):126–127. doi:10.1177/000992288402300215
  • Nakano O, Okita M, Miura M, et al. ク ロ ス ト リジ ウ ム菌 に よ る肝 膿 瘍 の1剖 検 例 [An autopsy case of clostridial liver abscess]. Nihon Naika Gakkai Zasshi. 1988;77(5):690–694. Japanese. doi:10.2169/naika.77.690
  • Eckel F, Lersch C, Huber W, Weiss W, Berger H, Schulte-Frohlinde E. Multimicrobial sepsis including Clostridium perfringens after chemoembolization of a single liver metastasis from common bile duct cancer. Digestion. 2000;62(2–3):208–212. doi:10.1159/000007815
  • Kreidl KO, Green GR, Wren SM. Intravascular hemolysis from a Clostridium perfringens liver abscess. J Am Coll Surg. 2002;194(3):387. doi:10.1016/s1072-7515(01)01169-3
  • Au WY, Lau LS. Massive haemolysis because of Clostridium perfringens [corrected] liver abscess in a patient on peritoneal dialysis. Br J Haematol. 2005;131(1):2. doi:10.1111/j.1365-2141.2005.05634.x
  • Ohtani S, Watanabe N, Kawata M, Harada K, Himei M, Murakami K. Massive intravascular hemolysis in a patient infected by a Clostridium perfringens. Acta Med Okayama. 2006;60(6):357–360. doi:10.18926/amo/30725
  • Daly JJ, Haeusler MN, Hogan CJ, Wood EM. Massive intravascular haemolysis with T-activation and disseminated intravascular coagulation due to clostridial sepsis. Br J Haematol. 2006;134(6):553. doi:10.1111/j.1365-2141.2006.06177.x
  • Umgelter A, Wagner K, Gaa J, Stock K, Huber W, Reindl W. Pneumobilia caused by a clostridial liver abscess: rapid diagnosis by bedside sonography in the intensive care unit. J Ultrasound Med. 2007;26(9):1267–1269. doi:10.7863/jum.2007.26.9.1267
  • Tabarelli W, Bonatti H, Cejna M, Hartmann G, Stelzmueller I, Wenzl E. Clostridium perfringens liver abscess after pancreatic resection. Surg Infect. 2009;10(2):159–162. doi:10.1089/sur.2008.014
  • Alarcón Del Agua I, Flores Cortés M, Pareja Ciuró F, Puppo Moreno A, Jiménez Rodríguez R. [Spontaneous rupture of a clostridium perfringens liver abscess into the abdominal cavity]. Absceso hepático por Clostridium perfringens abierto espontáneamente a la cavidad abdominal. Cir Esp. 2009;85(3):187–189. Spanish. doi:10.1016/j.ciresp.2008.04.003
  • Macías I, Salas de Zayas R, Zoila L, Dólera C. [Intravascular hemolysis due to Clostridium perfringens in an immunocompetent patient]. Hemólisis intravascular masiva por Clostridium perfringens en paciente inmunocompetente. Enferm Infecc Microbiol Clin. 2009;27(9):548–549. Spanish. doi:10.1016/j.eimc.2008.11.008
  • Meyns E, Vermeersch N, Ilsen B, Hoste W, Delooz H, Hubloue I. Spontaneous intrahepatic gas gangrene and fatal septic shock. Acta Chir Belg. 2009;109(3):400–404. doi:10.1080/00015458.2009.11680447
  • Rajendran G, Bothma P, Brodbeck A. Intravascular haemolysis and septicaemia due to Clostridium perfringens liver abscess. Anaesth Intensive Care. 2010;38(5):942–945. doi:10.1177/0310057x1003800522
  • van Bunderen CC, Bomers MK, Wesdorp E, Peerbooms P, Veenstra J. Clostridium perfringens septicaemia with massive intravascular haemolysis: a case report and review of the literature. Neth J Med. 2010;68(9):343–346.
  • Merino A, Pereira A, Castro P. Massive intravascular haemolysis during Clostridium perfrigens sepsis of hepatic origin. Eur J Haematol. 2010;84(3):278–279. doi:10.1111/j.1600-0609.2009.01337.x
  • Qandeel H, Abudeeb H, Hammad A, Ray C, Sajid M, Mahmud S. Clostridium perfringens sepsis and liver abscess following laparoscopic cholecystectomy. J Surg Case Rep. 2012;2012(1):5. doi:10.1093/jscr/2012.1.5
  • Kim JH, Jung ES, Jeong SH, et al. A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma. Korean J Hepatol. 2012;18(1):94–97. doi:10.3350/kjhep.2012.18.1.94
  • Imai J, Ichikawa H, Tobita K, Watanabe N. Liver abscess caused by Clostridium perfringens. Intern Med. 2014;53(8):917–918. doi:10.2169/internalmedicine.53.2139
  • Kurasawa M, Nishikido T, Koike J, Tominaga S, Tamemoto H. Gas-forming liver abscess associated with rapid hemolysis in a diabetic patient. World J Diabetes. 2014;5(2):224–229. doi:10.4239/wjd.v5.i2.224
  • Kusumoto K, Hamada A, Kusaka T, et al. 持続灌流ドレナージを行い救命可能であった敗血症をともなったClostridium perfringensによるガス産生性肝膿瘍の1例 [A patient with sepsis and a gas-forming liver abscess caused by Clostridium perfringens treated with continuous perfusion drainage]. Nihon Shokakibyo Gakkai zasshi. 2014;111(7):1416–1423. Japanese.
  • Kitterer D, Braun N, Jehs MC, Schulte B, Alscher MD, Latus J. Gas gangrene caused by clostridium perfringens involving the liver, spleen, and heart in a man 20 years after an orthotopic liver transplant: a case report. Exp Clin Transplant. 2014;12(2):165–168. doi:10.6002/ect.2013.0034
  • Eltawansy SA, Merchant C, Atluri P, Dwivedi S. Multi-organ failure secondary to a Clostridium perfringens gaseous liver abscess following a self-limited episode of acute gastroenteritis. Am J Case Rep. 2015;16:182–186. doi:10.12659/ajcr.893046
  • Khan MS, Ishaq MK, Jones KR. Gas-forming pyogenic liver abscess with septic shock. Case Rep Crit. 2015;2015:632873. doi:10.1155/2015/632873
  • Li JH, Yao RR, Shen HJ, et al. Clostridium perfringens infection after transarterial chemoembolization for large hepatocellular carcinoma. World J Gastroenterol. 2015;21(14):4397–4401. doi:10.3748/wjg.v21.i14.4397
  • Yoshida J, Nakamura H, Yamada S, et al. Clostridium perfringensを起因菌とするガス産生性肝膿瘍に乾燥ガス壊疽ウマ抗毒素を投与した1例 [A case of freeze-dried gas gangrene antitoxin for the treatment of Clostridium perfringens sepsis]. Nihon Shokakibyo Gakkai zasshi. 2015;112(2):332–338. Japanese. doi:10.11405/nisshoshi.112.332
  • Meeuwes FO, Hukshorn CJ, Bloembergen P. Severe abdominal pain three weeks after a hemi-hepatectomy. Neth J Med. 2015;73(8):392–393.
  • Kyang LS, Bin Traiki TA, Alzahrani NA, Morris DL. Microwave ablation of liver metastasis complicated by Clostridium perfringens gas-forming pyogenic liver abscess (GPLA) in a patient with past gastrectomy. Int J Surg Case Rep. 2016;27:32–35. doi:10.1016/j.ijscr.2016.08.009
  • García Carretero R, Romero Brugera M, Vazquez-Gomez O, Rebollo-Aparicio N. Massive haemolysis, gas-forming liver abscess and sepsis due to Clostridium perfringens bacteraemia. BMJ Case Rep. 2016;2016. doi:10.1136/bcr-2016-218014
  • Hashiba M, Tomino A, Takenaka N, et al. Clostridium perfringens infection in a febrile patient with severe hemolytic anemia. Am J Case Rep. 2016;17:219–223. doi:10.12659/ajcr.895721
  • Lim AG, Rudd KE, Halliday M, Hess JR. Hepatic abscess-associated Clostridial bacteraemia presenting with intravascular haemolysis and severe hypertension. BMJ Case Rep. 2016;2016. doi:10.1136/bcr-2015-213253
  • Paasch C, Wilczek S, Strik MW. Liver abscess and sepsis caused by Clostridium perfringens and Klebsiella oxytoca. Int J Surg Case Rep. 2017;41:180–183. doi:10.1016/j.ijscr.2017.10.033
  • Takemura K, Sekoguchi S, Yamane S, et al. 肝動脈化学塞栓療法後にClostridium perfringensによるガス産生性肝膿瘍を発症した1例 [A case of a gas-forming liver abscess caused by Clostridium perfringens after transcatheter arterial chemoembolization]. Nihon Shokakibyo Gakkai zasshi. 2018;115(6):554–562. Japanese. doi:10.11405/nisshoshi.115.554
  • Martí Gelonch L, Jiménez Agüero R, Rodríguez Canas N, Enríquez Navascués JM. Massive haemolysis due to sepsis caused by Clostridium perfringens secondary to liver abscess. Presentation of two cases with a similar history. Hemólisis masiva debida a sepsis por Clostridium perfringens secundaria a absceso hepático. Presentación de dos casos con un mismo antecedente. Gastroenterol Hepatol. 2018;41(9):562–563. doi:10.1016/j.gastrohep.2017.11.012
  • Guridi Mugica A, Marti Gelonch L, Jimenez Agüero R. Sepsis fulminante porClostridium perfringens. Med Intensiva. 2018;42(2):137. doi:10.1016/j.medin.2016.08.002
  • Hamada K, Sasaki Y. Gas-filled Cavities in the Liver. Intern Med. 2018;57(15):2277. doi:10.2169/internalmedicine.0172-17
  • Yoshikawa T, Ohana M, Fukuda A. High fever after radiofrequency ablation of hepatocellular carcinoma. Gastroenterology. 2018;155(2):e3–e4. doi:10.1053/j.gastro.2017.12.037
  • Amjad W, Chung S, Mumtaz M, Farooq A, Gondal N. Gaseous liver abscess with Clostridium perfringens sepsis in a patient with neutropaenia. Prz Gastroenterol. 2019;14(2):160–161. doi:10.5114/pg.2019.85902
  • Uojima H, Onoue M, Hidaka H, et al. A suspected case of Clostridium perfringens sepsis with intravascular hemolysis after transhepatic arterial chemoembolization: a case report. J Med Case Rep. 2019;13(1):125. doi:10.1186/s13256-019-2023-x
  • Lindberg Å, Wide D. [Sepsis with intravascular hemolysis caused by Clostridium perfringens]. Bakteriemi med C perfringens – ovanligt men livshotande tillstånd. Lakartidningen. 2019;2019:11. Swedish.
  • Sakaue M, Ota K, Nakamura E, et al. Type A fulminant Clostridium perfringens sepsis indicated RBC/Hb discrepancy; a case report. BMC Infect Dis. 2019;19(1):719. doi:10.1186/s12879-019-4350-3
  • Fujikawa H, Araki M. Clostridium perfringens septicemia with massive intravascular hemolysis. Intern Med. 2020;59(4):591. doi:10.2169/internalmedicine.3793-19
  • Dahl SS, Thorsteinsson M, Lambine TL, Penninga L. Severe sepsis caused by a gas-forming Clostridium perfringens and Klebsiella variicola liver abscess following total pancreatectomy. BMJ Case Rep. 2020;13(10). doi:10.1136/bcr-2020-238896
  • Hamura R, Haruki K, Kumagai Y, Shiba H, Wakiyama S, Yanaga K. Subphrenic abscess due to Clostridium perfringens after hepatic resection for hepatocellular carcinoma following emphysematous cholecystitis: report of a case. Int J Surg Case Rep. 2020;67:86–90. doi:10.1016/j.ijscr.2020.01.029
  • De Zylva J, Padley J, Badbess R, Dedigama M. Multiorgan failure following gastroenteritis: a case report. J Med Case Rep. 2020;14(1):74. doi:10.1186/s13256-020-02402-z
  • Olds KL, Gilbert JD, Byard RW. Unexpected Death Associated With Clostridial Sepsis. Am J Forensic Med Pathol. 2021;42(3):289–291. doi:10.1097/paf.0000000000000640
  • Wang MH, Kuo YH, Yen YH, et al. Hepatic Clostridium Perfringens Abscess Formation after Radiofrequency Ablation Therapy for Hepatocellular Carcinoma: report of a Rare Case. Case Rep Oncol. 2021;14(2):906–911. doi:10.1159/000517024
  • Satoh M, Kogure T, Koiwai A, et al. A gas-forming liver abscess with massive bleeding into the abscess cavity due to a ruptured inferior phrenic artery. Intern Med. 2021;60(24):3913–3919. doi:10.2169/internalmedicine.7746-21
  • Takahashi G, Nakamura Y, Hayakawa T, Ono T, Endo K, Yoshida H. Clostridium perfringens sepsis after pancreatoduodenectomy: a case report. Surg Case Rep. 2022;8(1):48. doi:10.1186/s40792-022-01402-z
  • Lang H, Schmidt JJ, Wedemeyer H, Busch M. [Sepsis with hemolysis due to a liver abscess in a 60-year-old male patient]. Sepsis mit Hämolyse im Rahmen eines Leberabszesses bei einem 60-jährigen Patienten. Internist. 2022;63(3):325–329. German. doi:10.1007/s00108-021-01227-2
  • Wong ACC, Chow EY. A case of severe intravascular haemolysis. EJHaem. 2022;3(3):1036–1037. doi:10.1002/jha2.520
  • Itoh N, Akazawa N, Yanaidani T, Kuwahara T. Clinical and microbiological features of intratumor abscess with bloodstream infection caused by plesiomonas shigelloides, citrobacter freundii, streptococcus mitis/oralis, clostridium perfringens, and Candida albicans in a patient with cholangiocarcinoma: a case report. J Infect Chemother. 2022;28(12):1677–1681. doi:10.1016/j.jiac.2022.08.024
  • Osório C, Silva D, Teles L, Ferreira T, Nora M. An unusual fatal outcome of laparoscopic cholecystectomy: a case report. Cureus. 2023;15(1):e34365. doi:10.7759/cureus.34365
  • Fujita H, Nishimura S, Kurosawa S, Akiya I, Nakamura-Uchiyama F, Ohnishi K. Clinical and epidemiological features of Clostridium perfringens bacteremia: a review of 18 cases over 8 year-period in a tertiary care center in metropolitan Tokyo area in Japan. Intern Med. 2010;49(22):2433–2437. doi:10.2169/internalmedicine.49.4041
  • Bendary MM, Abd El-Hamid MI, El-Tarabili RM, et al. Clostridium perfringens associated with foodborne infections of animal origins: insights into prevalence, antimicrobial resistance, toxin genes profiles, and toxinotypes. Biology. 2022;11(4):551. doi:10.3390/biology11040551
  • Park JY, Kim S, Oh JY, et al. Characterization of Clostridium perfringens isolates obtained from 2010 to 2012 from chickens with necrotic enteritis in Korea. Poult Sci. 2015;94(6):1158–1164. doi:10.3382/ps/pev037
  • Udhayavel S, Thippichettypalayam Ramasamy G, Gowthaman V, Malmarugan S, Senthilvel K. Occurrence of Clostridium perfringens contamination in poultry feed ingredients: isolation, identification and its antibiotic sensitivity pattern. Anim Nutr. 2017;3(3):309–312. doi:10.1016/j.aninu.2017.05.006
  • Shindo Y, Dobashi Y, Sakai T, Monma C, Miyatani H, Yoshida Y. Epidemiological and pathobiological profiles of Clostridium perfringens infections: review of consecutive series of 33 cases over a 13-year period. Int J Clin Exp Pathol. 2015;8(1):569–577.
  • Simon TG, Bradley J, Jones A, Carino G. Massive intravascular hemolysis from Clostridium perfringens septicemia: a review. J Intensive Care Med. 2014;29(6):327–333. doi:10.1177/0885066613498043
  • Stevens DL, Maier KA, Mitten JE. Effect of antibiotics on toxin production and viability of Clostridium perfringens. Antimicrob Agents Chemother. 1987;31(2):213–218. doi:10.1128/AAC.31.2.213
  • Korhonen K. Hyperbaric oxygen therapy in acute necrotizing infections. With a special reference to the effects on tissue gas tensions. Ann Chir Gynaecol. 2000;89(214):7–36.
  • Hirn M, Niinikoski J, Lehtonen OP. Effect of hyperbaric oxygen and surgery on experimental gas gangrene. Eur Surg Res. 1992;24(6):356–362. doi:10.1159/000129228