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Case Reports
. 2019 Apr 24;11(4):e4539.
doi: 10.7759/cureus.4539.

Frightening" Resistant Clostridial Myonecrosis: A Case Report

Syed Adeel Hassan  1 , Ali Akhtar  2 , Maham Khan  3 , Fahad N Sheikh  4 , Hannan Asghar  5
Affiliations
Case Reports

Frightening" Resistant Clostridial Myonecrosis: A Case Report

Syed Adeel Hassan et al. Cureus. .

Abstract

Clostridial myonecrosis is a diffuse necrotizing infection of deep soft tissues. It is known for its acute, rapid progression, poor prognosis, and high mortality. We report a case of traumatic clostridial myonecrosis, a 17-year-old, previously healthy female reported to our department with the complaint of pain in her left arm a week after she suffered a fall from her chair on to her left arm. Due to the injury sustained in the incident, under suspicion of a forearm fracture, a cast was applied to her left arm at a local polyclinic. However, after a few days, she reported unbearable pain, which led to the removal of the cast, and that is when diffuse crepitations due to gaseous accumulation were noted in her entire left upper limb. A week later, X-ray studies failed to reveal any fracture or abnormality. The patient was started on broadspectrum antibiotic coverage with intravenous (IV) benzylpenicillin, rifampicin, and clindamycin for a considerable period of time, but there was no improvement in her condition and the infection continued to spread into adjacent soft tissues, requiring intervention with hyperbaric oxygen therapy.

Keywords: alpha toxin; anaerobic infection; clostridium bifermentans; clostridium perfringens; clostridium sordelli; crepitations; gas gangrene; hyperbaric oxygen; myonecrosis; traumatic infection.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Left hand, post removal of the cast
Note the early puckering of the skin associated with minimal swelling and gas accumulation.
Figure 2
Figure 2. Left hand, few days after the removal of the cast
Note the diffuse and rapid spread of tissue involvement. Also of significance is the marbling of the skin in the involved area due to gaseous accumulation.
See this image and copyright information in PMC

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References

    1. Buboltz JB, Murphy-Lavoie HM. National Center For Biotechnology Information, U.S. National Library of Medicine. NBK537030. Treasure Island (FL): StatPearls Publishing LLC; [Mar;2019 ]. 2019. Gas gangrene. - PubMed
    1. Clostridial myonecrosis. [Mar;2019 ];https://rarediseases.org/rare-diseases/clostridial-myonecrosis/ 2019
    1. Epidemiological and pathobiological profiles of clostridium perfringens infections: review of consecutive series of 33 cases over a 13-year period. Shindo Y, Dobashi Y, Sakai T, Monma C, Miyatani H, Yoshida Y. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348875/ Int J Clin Exp Pathol. 2015;8:569–577. - PMC - PubMed
    1. Gas gangrene: case presentation and literature data. Hanganu B, Neagu M, Manoilescu I, Velnic A, Ioan BG. J Surg. 2017;13:139–142.
    1. Gas gangrene in orthopaedic patients. Ying Z, Zhang M, Yan S, Zhu Z. Case Rep Orthop. 2013;2013:942076. - PMC - PubMed

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