RBC Ghosts

Q: Red Blood Cell (RBC) ghosts can be seen mostly with which bacterial infection?

Answer: Clostridium perfringens

RBC ghosts are RBC membranes devoid of hemoglobin. This occurs when intravascular lysis causes hemoglobin to leak into the plasma. RBC ghosts are usually seen in fulminant bacteremia, and most commonly with Clostridium perfringens. Other major infections that may create RBC ghosts are:

• Malaria
• Babesia
• Leishmania
• Bartonella
• Protozoa

C. perfringens can cause massive, life-threatening hemolysis via its alpha toxin, a pore-forming toxin that binds glycosylphosphatidylinositol (GPI) anchored proteins and inserts into cell membranes. Interestingly, this massive hemolysis may give rise to laboratory errors, such as faulty sample collection.

#hematology

#ID

#laboratory-science

References:

1. Hübl W, Mostbeck B, Hartleb H, et al. Investigation of the pathogenesis of massive hemolysis in a case of Clostridium perfringens septicemia. Ann Hematol 1993; 67:145.

2. Kennedy CL, Lyras D, Cordner LM, et al. Pore-forming activity of alpha-toxin is essential for clostridium septicum-mediated myonecrosis. Infect Immun 2009; 77:943.

3. Rodriguez FJ, Ritter MJ, Tauscher CD, Moore SB. Transfusion medicine illustrated. Massive hemolysis secondary to alpha-toxin release. Transfusion 2005; 45:127.