{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:10:37Z","timestamp":1785420637268,"version":"3.56.0"},"reference-count":6,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Clostridium perfringens<\/jats:italic>\n is an anaerobic spore-forming bacterium capable of producing fulminant infections through potent exotoxins. We report the case of an elderly man with multiple comorbidities who presented with acute abdominal pain and vomiting. Within 24 hours, the patient developed abrupt clinical deterioration characterised by altered mental status, rapidly progressive anaemia, metabolic acidosis and multiorgan dysfunction. A CT scan demonstrated multiple gas-containing hepatic lesions without a well-defined fluid collection, compatible with emphysematous hepatitis. Blood cultures rapidly confirmed\n C. perfringens<\/jats:italic>\n . Despite prompt escalation of antimicrobial therapy and intensive supportive management, the patient developed progressive multiorgan failure and died 96 hours after admission. Although\n C. perfringens<\/jats:italic>\n liver abscesses associated with haemolysis have been previously described, reports combining fulminant haemolysis with a radiological pattern consistent with emphysematous hepatitis remain exceedingly rare. This case highlights the importance of early recognition of this catastrophic presentation and the need for immediate antimicrobial therapy and source control whenever feasible.\n <\/jats:p>","DOI":"10.1136\/bcr-2026-272231","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:25:14Z","timestamp":1785417914000},"page":"e272231","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fulminant emphysematous hepatitis with massive intravascular haemolysis due to\n Clostridium perfringens<\/i>\n infection"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6459-5052","authenticated-orcid":false,"given":"Queralt","family":"Herms","sequence":"first","affiliation":[{"name":"Liver ICU, Liver Unit, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"},{"name":"Institut d'Indvestigacions Biom\u00e8diques August Pi i Sunyer, IDIBAPS, Universidad de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Liver ICU, Liver Unit, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"},{"name":"Institut d'Indvestigacions Biom\u00e8diques August Pi i Sunyer, IDIBAPS, Universidad de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Merino","sequence":"additional","affiliation":[{"name":"Biochemistry and Molecular Genetics Department, Core Laboratory, Biomedical Diagnostic Centre, Hospital Cl\u00ednic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Liver ICU, Liver Unit, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"},{"name":"Institut d'Indvestigacions Biom\u00e8diques August Pi i Sunyer, IDIBAPS, Universidad de Barcelona, Barcelona, Spain"},{"name":"EF Clif, EASL-CLIF Consortium, Hospital Clinic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026073006250814000_19.7.e272231.1","first-page":"376","article-title":"Emphysematous hepatitis in a diabetic patient","volume":"23","author":"Kim","year":"2009","journal-title":"Can J Gastroenterol"},{"key":"2026073006250814000_19.7.e272231.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e33279","article-title":"Clostridium perfringens sepsis after comprehensive multicourse treatment of hepatocellular carcinoma: A case report and review","volume":"10","author":"Zhang","year":"2024","journal-title":"Heliyon"},{"key":"2026073006250814000_19.7.e272231.3","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms11092137","article-title":"Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology","volume":"11","author":"Porez","year":"2023","journal-title":"Microorganisms"},{"key":"2026073006250814000_19.7.e272231.4","first-page":"1164466","article-title":"A fatal case of Clostridium perfringens septicemia with massive intravascular hemolysis and a literature review","volume":"10","author":"Wen","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"2026073006250814000_19.7.e272231.5","first-page":"714","article-title":"Septicemia and hemolysis due to Clostridium perfringens","volume":"51","author":"Lee","year":"2023","journal-title":"J Clin Ultrasound"},{"key":"2026073006250814000_19.7.e272231.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2009.01337.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:25:16Z","timestamp":1785417916000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":6,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-272231"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272231","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}