Massive acute hemolysis secondary to Clostridium perfringens sepsis in a recently transfused oncology patient with multiple alloantibodies.

Sepsis with clostridia species is seen infrequently in oncology patients, and the massive acute intravascular hemolysis known to be associated with these organisms is rare. The urgency of making the diagnosis of clostridial sepsis is imperative since the course is rapidly fatal if untreated. We describe a patient with metastatic adenocarcinoma of the pancreas, known to have recent transfusions as well as multiple red cell alloantibodies, who developed massive nonimmunologic hemolysis associated with Clostridium perfringens sepsis. Because the hemolysis of C. perfringens sepsis can mimic that of a severe delayed hemolytic transfusion reaction, care must be taken to differentiate these conditions, especially in view of the frequency of transfusion in these patients as well as their predisposition to develop disseminated infections.