Clostridium perfringens infection after transarterial chemoembolization for large hepatocellular carcinoma

Abstract

We report an unusual case of Clostridium perfringens liver abscess formation after transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma. Severe deterioration in liver and renal function accompanied with hemocytolysis was found on the 2(nd) day after TACE. Blood culture found Clostridium perfringens and abdominal computed tomography revealed a gas-containing abscess in the liver. Following antibiotics administration and support care, the infection was controlled and the liver and renal function turned normal. The 2(nd) TACE procedure was performed 1.5 mo later and no recurrent Clostridium perfringens infection was found.

Keywords: Clostridium perfringens; Hepatocellular carcinoma; Liver abscess; Major complication; Transcatheter arterial chemoembolization.

Figure 1

Magnetic resonance imaging and computed tomography findings. A-C: Magnetic resonance imaging (MRI) images before transcatheter arterial chemoembolization (TACE); D-F: Computed tomography (CT) images showing a gas-forming liver abscess when the first TACE was done; G-I: Five week after the first TACE procedure, CT image showed that the gas-forming liver abscess became smaller; J-L: Eleven week after the first TACE procedure, MRI showed no obvious liver abscess.