Hepatic Abscess With Clostridium perfringens Bacteremia Leading to Hemolysis: A Case Report

TL;DR

A 64-year-old man developed a liver abscess caused by Clostridium perfringens, leading to severe blood cell breakdown and kidney failure.

Contribution

This case highlights the rare but severe complications of C. perfringens hepatic abscess and sepsis.

Findings

C. perfringens from a liver abscess caused intravascular hemolysis and acute renal failure.

Prompt antibiotic therapy and abscess drainage improved clinical outcomes.

Early recognition is critical to managing C. perfringens sepsis.

Abstract

We describe the case of a 64-year-old male who presented with acute acalculous cholecystitis complicated by the formation of a hepatic abscess. Blood cultures subsequently grew Clostridium perfringens, and culture of the aspirated hepatic abscess fluid confirmed its presence. The clinical course was further complicated by severe intravascular hemolysis, leading to acute renal failure that required temporary hemodialysis.

Management included the prompt initiation of broad-spectrum intravenous antibiotic therapy in conjunction with image-guided percutaneous drainage of the hepatic abscess. C. perfringens sepsis is associated with high morbidity and mortality, primarily due to its rapid progression and toxin-mediated hemolysis. This case underscores the importance of early recognition, aggressive antimicrobial therapy, and timely source control to optimize clinical outcomes.

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