Fatal Clostridium perfringens sepsis due to emphysematous gastritis and literature review

• We report a very rapid and severe case of C. perfringens infection.
• Abdominal CT scan proved the presence of gas bubbles in the stomach, small intestines and liver were seen.
• The gastric alterations pointed to emphysematous gastritis.
• The post-mortem microbiological cultures confirmed the presence of Clostridium perfringens in many abdominal organs.

A 76-year-old female patient was admitted to the Level I Emergency Department of University of Szeged with severe abdominal pain and vomiting. The clinical assessment with laboratory tests and radiological investigations confirmed severe sepsis associated with intravascular hemolysis and multiorgan failure and acute pancreatitis. On the abdominal CT, besides of other abnormalities, the presence of gas bubbles in the stomach, small intestines and liver were seen. The gastric alterations pointed to emphysematous gastritis. Despite of the medical treatment, the patient's condition quickly deteriorated and eight hours after admission the patient died. The autopsy evaluation revealed systemic infection of abdominal origin caused by gas-producing Gram-positive bacteria, and the post-mortem microbiological cultures confirmed the presence of Cloctridium perfringens in many abdominal organs. Emphysematous gastritis seemed to be the primary infectious focus.