To improve the clinicians’ understanding of rare complications of Clostridium perfringens.

The clinical data of a patient with intravascular hemolysis and liver abscess caused by Clostridium perfringenes infection who was admitted to Yantai Yuhuangding Hospital in February 2023 was analyzed, retrospectively. Relevant literatures at domestic and abroad were searched to explore the pathogenic mechanism, clinical characteristics, diagnosis and treatment of the disease.

An elderly man with a history of diabetes was admitted to the hospital due to acute pancreatitis with intra-abdominal infection. On the second day of admission, the patient experienced shortness of breath, chest tightness, and dark urine resembling soy sauce. Laboratory tests (hemoglobin: 63 g/L, total bilirubin: 64.9 μmol/L, indirect bilirubin: 55.1 μmol/L) indicated intravascular hemolysis, blood smear showed spherocytic red blood cells, and blood culture revealed Clostridium perfringens. Abdominal CT and ultrasound showed a liver abscess, leading to a diagnosis of acute intravascular hemolysis and liver abscess caused by Clostridium perfringens.

Clostridium perfringens infection accompanied by intravascular hemolysis and liver abscess is a rare complication with an extremely high mortality rate. Clinical physicians should identify, diagnose and treat early to improve the prognosis of the patient.