Fatal Clostridium perfringens septicemia associated with gastrointestinal arteriovenous malformations (vascular ectasias)

Abstract

Clostridial infections usually occur in association with trauma, malignancy, or intra-abdominal disease. A 72-year-old previously healthy man presented with abdominal distress and fever. He developed a hemolytic anemia, coagulopathy, and fulminant clostridial septicemia. The patient died less than 24 hours after presentation. At autopsy, no malignancy was detected. The patient had an acute clostridial hepatic abscess and multiple arteriovenous malformations (vascular ectasias) of the large and small bowel. The case suggests that these mucosal and submucosal vascular lesions, which usually cause hemorrhage, may also predispose to infection.