Spontaneous clostridial myonecrosis (gas gangrene) is an uncommonly encountered presentation of skin and soft-tissue infections with high morbidity and mortality.
The diagnosis has been associated with colorectal carcinoma, hematologic malignancies, and diabetes.
We report the case of an 81-year-old man who experienced a sudden onset of left ankle and foot pain in association with nonpalpable purpura and hemorrhagic bulla.
The diagnosis was initially suspected on clinical presentation, gas in tissue on plain-film radiography, and Gram staining of aspirated bulla contents.
Cultures grew Clostridium septicum, and a large cecum mass was found by computed tomography of the abdomen. A subsequent right hemicolectomy confirmed a well to moderately differentiated mucinous adenocarcinoma.
We emphasized that the early recognition of necrotizing skin and soft-tissue infections warrants further evaluation and appropriate management.
2011-11-23
Eng.
Division of Infectious Diseases, Department of Medicine, University of Kentucky College of Medicine, A.B. Chandler Medical Center, Lexington, KY 40536-0298, USA. william.wright [at] uky.edu
Am J Emerg Med. 2012 Jan;30(1):253.e3-5
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