array:23 [
  "pii" => "S2173572718300018"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2018.01.001"
  "estado" => "S300"
  "fechaPublicacion" => "2018-03-01"
  "aid" => "967"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Med Intensiva. 2018;42:137"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1599
    "formatos" => array:3 [
      "EPUB" => 205
      "HTML" => 880
      "PDF" => 514
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569116301772"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2016.08.002"
      "estado" => "S300"
      "fechaPublicacion" => "2018-03-01"
      "aid" => "967"
      "copyright" => "Elsevier España, S.L.U. y SEMNIM"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Med Intensiva. 2018;42:137"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2705
        "formatos" => array:3 [
          "EPUB" => 181
          "HTML" => 1691
          "PDF" => 833
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Im&#225;genes en Medicina Intensiva</span>"
        "titulo" => "Sepsis fulminante por <span class="elsevierStyleItalic">Clostridium perfringens</span>"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "137"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Fulminant sepsis caused by <span class="elsevierStyleItalic">Clostridium perfringens</span>"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:6 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 350
                "Ancho" => 867
                "Tamanyo" => 73887
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "A&#46; Guridi Mugica, L&#46; Marti Gelonch, R&#46; Jimenez Ag&#252;ero"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Guridi Mugica"
              ]
              1 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Marti Gelonch"
              ]
              2 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Jimenez Ag&#252;ero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572718300018"
          "doi" => "10.1016/j.medine.2018.01.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300018?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116301772?idApp=WMIE"
      "url" => "/02105691/0000004200000002/v1_201802250513/S0210569116301772/v1_201802250513/es/main.assets"
    ]
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173572718300079"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2018.01.003"
    "estado" => "S300"
    "fechaPublicacion" => "2018-03-01"
    "aid" => "1036"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2018;42:135-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1289
      "formatos" => array:3 [
        "EPUB" => 181
        "HTML" => 636
        "PDF" => 472
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Improvement of the safety of a clinical process using failure mode and effects analysis&#58; Prevention of venous thromboembolic disease in critically ill patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "135"
          "paginaFinal" => "136"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Mejora en la seguridad de un proceso cl&#237;nico utilizando el an&#225;lisis modal de fallos y efectos&#58; profilaxis de la enfermedad tromboemb&#243;lica venosa en pacientes cr&#237;ticos"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Viejo Moreno, J&#46;A&#46; S&#225;nchez-Izquierdo Riera, E&#46; Molano &#193;lvarez, J&#46;A&#46; Barea Mendoza, S&#46; Temprano V&#225;zquez, L&#46; D&#237;az Castellano, J&#46;C&#46; Montejo Gonz&#225;lez"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Viejo Moreno"
            ]
            1 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "S&#225;nchez-Izquierdo Riera"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Molano &#193;lvarez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Barea Mendoza"
            ]
            4 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Temprano V&#225;zquez"
            ]
            5 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "D&#237;az Castellano"
            ]
            6 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "Montejo Gonz&#225;lez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S021056911730058X"
        "doi" => "10.1016/j.medin.2017.01.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911730058X?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300079?idApp=WMIE"
    "url" => "/21735727/0000004200000002/v1_201803150431/S2173572718300079/v1_201803150431/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Image in Intensive Medicine</span>"
    "titulo" => "Fulminant sepsis caused by <span class="elsevierStyleItalic">Clostridium perfringens</span>"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "137"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Guridi Mugica, L&#46; Marti Gelonch, R&#46; Jimenez Ag&#252;ero"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Guridi Mugica"
            "email" => array:1 [
              0 => "amalur&#46;guridimugica&#64;osakidetza&#46;eus"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Marti Gelonch"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Jimenez Ag&#252;ero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Donostia&#44; Donostia-San Sebasti&#225;n&#44; Guip&#250;zcoa&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Cirug&#237;a General&#44; Hospital Universitario Donostia&#44; Donostia-San Sebasti&#225;n&#44; Guip&#250;zcoa&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Sepsis fulminante por <span class="elsevierStyleItalic">Clostridium perfringens</span>"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:6 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 350
            "Ancho" => 867
            "Tamanyo" => 73284
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 66-year-old male was admitted due to abdominal septic shock and a liver abscess identified by the CT scan &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The blood samples revealed advanced hemolysis&#44; with the presence of erythrocyte ghosts &#40;thin arrows&#41; and spherocytes &#40;thick arrows&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The blood cultures proved positive for <span class="elsevierStyleItalic">Clostridium perfringens</span>&#46; The clinical course was negative&#44; leading to multiorgan dysfunction with progressive metabolic acidosis&#44; anemization and thrombocytopenia&#46; Treatment proved ineffective&#44; and the patient died after three hours&#46; Sepsis due to <span class="elsevierStyleItalic">C&#46; perfringens</span> has a very poor prognosis if not detected early&#46; The disorder should be suspected in the case of a septic patient with evidence of massive hemolysis&#44; and blood cultures with gram staining of the blood smear are indicated&#46; Early empirical antibiotic treatment with penicillin and clindamycin should be started&#44; and local debridement is to be performed&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Guridi Mugica A&#44; Marti Gelonch L&#44; Jimenez Ag&#252;ero R&#46; Sepsis fulminante por <span class="elsevierStyleItalic">Clostridium perfringens</span>&#46; Med Intensiva&#46; 2018&#59;42&#58;137&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:6 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 350
            "Ancho" => 867
            "Tamanyo" => 73284
          ]
        ]
      ]
      1 => array:6 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 350
            "Ancho" => 945
            "Tamanyo" => 32180
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004200000002/v1_201803150431/S2173572718300018/v1_201803150431/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "66582"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Image in Intensive Medicine"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004200000002/v1_201803150431/S2173572718300018/v1_201803150431/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718300018?idApp=WMIE"
]
Share
Journal Information
Vol. 42. Issue 2.
Pages 137 (March 2018)
Image in Intensive Medicine
Full text access
Fulminant sepsis caused by Clostridium perfringens
Sepsis fulminante por Clostridium perfringens
Visits
13159
A. Guridi Mugicaa,
Corresponding author
, L. Marti Gelonchb, R. Jimenez Agüerob
a Servicio de Medicina Intensiva, Hospital Universitario Donostia, Donostia-San Sebastián, Guipúzcoa, Spain
b Servicio de Cirugía General, Hospital Universitario Donostia, Donostia-San Sebastián, Guipúzcoa, Spain
This item has received
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

A 66-year-old male was admitted due to abdominal septic shock and a liver abscess identified by the CT scan (Fig. 1). The blood samples revealed advanced hemolysis, with the presence of erythrocyte ghosts (thin arrows) and spherocytes (thick arrows) (Fig. 2). The blood cultures proved positive for Clostridium perfringens. The clinical course was negative, leading to multiorgan dysfunction with progressive metabolic acidosis, anemization and thrombocytopenia. Treatment proved ineffective, and the patient died after three hours. Sepsis due to C. perfringens has a very poor prognosis if not detected early. The disorder should be suspected in the case of a septic patient with evidence of massive hemolysis, and blood cultures with gram staining of the blood smear are indicated. Early empirical antibiotic treatment with penicillin and clindamycin should be started, and local debridement is to be performed.

Figure 1
(0.07MB).
Figure 2
(0.03MB).

Please cite this article as: Guridi Mugica A, Marti Gelonch L, Jimenez Agüero R. Sepsis fulminante por Clostridium perfringens. Med Intensiva. 2018;42:137.

Copyright © 2016. Elsevier España, S.L.U. and SEMICYUC
Download PDF
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools