Clostridium perfringens bloodstream infection secondary to acute pancreatitis: A case report

BACKGROUND: Clostridium perfringens (C. perfringens) is an opportunistic pathogen. It can cause infections after birth, after an abortion, and in patients with diabetes, malignancy, liver cirrhosis, or an immunosuppressive state. Here, we report a patient with C. perfringens infection secondary to acute pancreatitis, with no underlying diabetes, malignancy, or liver cirrhosis. CASE SUMMARY: A 62-year-old Han Chinese woman presented to the Tianjin Hospital of ITCWM Nankai Hospital on January 8, 2020 because of epigastric abdominal pain. Laboratory examination showed that urine amylase was 10403 U/L (reference: 47-458), and blood amylase was 1006 U/L (reference: < 100). Abdominal computed tomography showed pancreatic edema and peripancreatic exudation. She was diagnosed with mild acute pancreatitis and treated accordingly. She was readmitted the next day for similar symptoms. Two hours later, she went to the lavatory and urinated, and the urine color was like soy sauce. Oxygen saturation decreased to 77%, and she developed consciousness disturbance. She was admitted to the intensive care unit. After 8 h in the hospital, she had a high fever of 40 ℃, blood was drawn for culture, and 3 g of cefoperazone/sulbactam was administered. After 12 h, she had a cardiac arrest and died shortly. Blood culture confirmed a C. perfringens infection. CONCLUSION: C. perfringens infection may be secondary to acute pancreatitis. Rapid recognition and aggressive early management are critical for the survival of patients with C. perfringens infection.