Abstract
Introduction The incidence of Clostridium perfringens bacteremia in the general hospital population is low, ranging fkom 0.3 to 2.6%. The clinical spectrum of disease varies from a positive blood culture in an otherwise asymptomatic patient to fulminant sepsis characterized by fever, hy-potension, and, in some cases, massive intravascular hemolysis. The overall prognosis in this population is poor, especially when acute hemolytic anemia, gas gangrene, or diffise spreading cellulitis supervenes. We describe a case of fatal C. perfiingens bacteremia complicating the course of a 47-year-old male with a perforated colonic adenocarcinoma. The most common malignancies complicated by C. perfringens are leukemias and solid tumors of the genitourinary and gastrointestinal tracts. We comment on interesting clinicopathologic aspects of the case, including the association with malignancy, rapidly developing massive intravascular hemolysis, and diagnostic considerations.
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