W. Hubl et al., INVESTIGATION OF THE PATHOGENESIS OF MASSIVE HEMOLYSIS IN A CASE OF CLOSTRIDIUM-PERFRINGENS SEPTICEMIA, Annals of hematology, 67(3), 1993, pp. 145-147
Massive hemolysis is a rare, usually fatal complication of Clostridium
perfringens septicemia. Of all toxins produced by the bacterium, phos
pholipase C (PLC) is believed to be the most likely cause of hemolysis
. An influence of neuraminidase has often been suspected. In the prese
nt study, a case of C perfringens septicemia with acute massive intrav
ascular hemolysis is described. It led to death within 4 h of admissio
n to the hospital. While the course of events was comparable to previo
usly reported cases, we succeeded in gaining deeper insight into the p
athogenesis by monitoring serum anti-T titer and quantifying serum PLC
activity during the course of the disease. We excluded an effect of n
euraminidase 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 ac
tivity, on the other hand, showed a nearly fivefold increase (6.0 to 2
7.3 U/l), which is consistent with the hypothesized dominant role of t
his enzyme.