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Massive intravascular hemolysis induced by this bacterium is a rare presentation reported in only 7% to 15% of cases of Clostridium Perfringens bacteremia with a mortality rate reaching 90%.We present the case of a middle-aged man with metastatic melanoma having black-colored urine as the first sign of massive hemolysis along with mild methemoglobinemia. Despite timely management, the patient progressed into septic shock with severe hypoxia and passed away. Postmortem, blood cultures grew clostridium perfringens. Black-colored urine and blood samples, sepsis-induced mild methemoglobinemia and acute massive hemolysis should raise concern for Clostridium Perfringens sepsis in the appropriate clinical settings.<\/jats:p>","DOI":"10.1177\/1179547620981894","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T02:39:21Z","timestamp":1608863961000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0245-9267","authenticated-orcid":false,"given":"Salwa A","family":"Koubaissi","sequence":"first","affiliation":[{"name":"Pulmonary and Critical Care Division, Department of Internal Medicine, American University of Beirut Medical Center, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem 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