[P170] Acral bullous eruption in a septic patient with Clostridium perfringens bacteremia = [P170] Acral bullous eruption in a septic patient with Clostridium perfringens bacteremia

다국어 초록 (Multilingual Abstract)

Sepsis is a life-threatening condition that is caused by an immune response triggered by an infection. Skin symptoms are mainly desquamation and rash, but the symptoms vary depending on the causative strain. A 69-year-old male came to our clinic complaining of bullae on both hands and feet. Vital signs indicated sepsis and laboratory test showed leukocytosis. Skin biopsy taken from his hand, foot showed subepidermal and subcorneal bullae with eosinophils in bullae cavity. There was no suspicious drug that could have caused bullous eruption and no parasite antigens were detected. Later systemic Clostridium perfringens bacteremia was confirmed through blood culture. After the administration of antibiotics, septic condition improved along with skin lesions. So we concluded that the skin lesion was caused by systemic C. perfringens infection. Toxin mediated blister can occur from infection with strains of C. perfringens which produces C. perfringens enterotoxin, resulting in the reversible loss of tight junction integrity. Furthemore, C. perfringens enterotoxin acts as a superantigen and can induce nonspecific activation of T cells, which can cause a toxic shock like syndrome. So we herein report a first case of acral bullous eruption caused by C. perfringens enterotoxin.