Fatal Liver Infection Caused By Clostridium perfringens After Common Bile Duct Stenting Due To Pancreatic Cancer: A Case Report

Figures & data

Table 1 Complete Blood Count

Time	WBC	Hgb	PLT
2 pm, March 8th	19.72	7.7	46
9 pm, March 8th	25.14	8.0	22
9 am, March 9th	24.82	8.3	15
Normal range and unit	4–10/mm^3	11.6–15.5 g/dL	152–358/mm^3

Abbreviations: WBC, white blood cell; RBC, red blood cell; Hgb, hemoglobin; PLT, platelet.

Table 2 Coagulation Studies And Myocardial Markers

Time	PT	INR	APTT	TT	PTA	FIB	D-Dimer	TnI	TnT	CK-MB	BNP
2 pm, March 8th	17.4	1.49	47.4	15.2	56%	6.86	2171	0.08	62	4	193.31
9 pm, March 8th	18.9	1.62	51.6	15.1	50%	6.16	2686	0.2	87	13.2	224.32
9 am, March 9th	20.8	1.78	54.8	14.6	44%	5.74	2522	0.17	429.5	10.4	245.28
Normal range and unit	8.8–13.4 s	0.8–1.5	23.3–38.1 s	11.0–17.8 s	70–160%	2–4 g/L	<255 ng/mL	0–0.04 ng/mL	0–70 ng/mL	0–5 ng/mL	<100 pg/mL

Abbreviations: PT, prothrombin time; INR, international normalized ratio; APTT, activated partial thromboplastin time; TT, thrombin time; PTA, prothrombin time activity; FIB, fibrinogen; BNP, B-type natriuretic peptide.

Table 3 Serum Biochemistry Levels

Time	ALT	AST	LDH	TBIL	DBIL	Cre	BUN	Glu	ALB
2 pm, Mar. 8th	750	1426	981	60.7	57.9	149	35.51	6.7	19
9 pm, Mar. 8th	878	1679	1279	69.7	63.7	164	37.47	6.1	17
9 am, Mar. 9th	1094	1970	1810	79.7	74.1	172	38.94	8.2	18
Normal range and unit	5–40 U/L	13–40 U/L	100–300 U/L	2–21 μmol/L	1.7–8.1 μmol/L	59–104 μmol/L	2.9–8.2 mmol/L	3.9–6.1 mmol/L	34–48 g/L

Abbreviations: ALT, alanine aminotransferase; AST, aspartate transaminase; LDH, lactate dehydrogenase; TBIL, total bilirubin; DBIL, direct bilirubin; Cre, creatinine; BUN, blood urea nitrogen; Glu, glucose; ALB, albumin.

Figure 1 (A)–(C) Abdominal computed tomography (CT) before stenting revealed intrahepatic duct dilation due to obstruction of pancreatic mass. (D)–(F) Emergency CT showed gas-containing lesions in the liver, containing liver parenchymal moth-eaten destruct and pneumatized bile duct without obvious inflammation around. (F) The stent was right in the common bile duct without obstruction.