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Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens

Clostridium Perfringens is an anaerobic gram-positive bacillus able to produce different types of toxins and can cause septicemia. The mechanism is through translocation from a previously colonized gastrointestinal or genital tract. Massive intravascular hemolysis induced by this bacterium is a rare...

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Autores principales: Koubaissi, Salwa A, Al Assaad, Reem G, Itani, Ziad, Bouakl, Imad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768566/
https://www.ncbi.nlm.nih.gov/pubmed/33488133
http://dx.doi.org/10.1177/1179547620981894
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author Koubaissi, Salwa A
Al Assaad, Reem G
Itani, Ziad
Bouakl, Imad
author_facet Koubaissi, Salwa A
Al Assaad, Reem G
Itani, Ziad
Bouakl, Imad
author_sort Koubaissi, Salwa A
collection PubMed
description Clostridium Perfringens is an anaerobic gram-positive bacillus able to produce different types of toxins and can cause septicemia. The mechanism is through translocation from a previously colonized gastrointestinal or genital tract. Massive intravascular hemolysis induced by this bacterium is a rare presentation reported in only 7% to 15% of cases of Clostridium Perfringens bacteremia with a mortality rate reaching 90%.We present the case of a middle-aged man with metastatic melanoma having black-colored urine as the first sign of massive hemolysis along with mild methemoglobinemia. Despite timely management, the patient progressed into septic shock with severe hypoxia and passed away. Postmortem, blood cultures grew clostridium perfringens. Black-colored urine and blood samples, sepsis-induced mild methemoglobinemia and acute massive hemolysis should raise concern for Clostridium Perfringens sepsis in the appropriate clinical settings.
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spelling pubmed-77685662021-01-21 Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens Koubaissi, Salwa A Al Assaad, Reem G Itani, Ziad Bouakl, Imad Clin Med Insights Case Rep Case Report Clostridium Perfringens is an anaerobic gram-positive bacillus able to produce different types of toxins and can cause septicemia. The mechanism is through translocation from a previously colonized gastrointestinal or genital tract. Massive intravascular hemolysis induced by this bacterium is a rare presentation reported in only 7% to 15% of cases of Clostridium Perfringens bacteremia with a mortality rate reaching 90%.We present the case of a middle-aged man with metastatic melanoma having black-colored urine as the first sign of massive hemolysis along with mild methemoglobinemia. Despite timely management, the patient progressed into septic shock with severe hypoxia and passed away. Postmortem, blood cultures grew clostridium perfringens. Black-colored urine and blood samples, sepsis-induced mild methemoglobinemia and acute massive hemolysis should raise concern for Clostridium Perfringens sepsis in the appropriate clinical settings. SAGE Publications 2020-12-24 /pmc/articles/PMC7768566/ /pubmed/33488133 http://dx.doi.org/10.1177/1179547620981894 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Koubaissi, Salwa A
Al Assaad, Reem G
Itani, Ziad
Bouakl, Imad
Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title_full Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title_fullStr Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title_full_unstemmed Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title_short Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens
title_sort black urine and methemoglobinemia in the setting of sepsis due to clostridium perfringens
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768566/
https://www.ncbi.nlm.nih.gov/pubmed/33488133
http://dx.doi.org/10.1177/1179547620981894
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