title: Clostridial myonecrosis resulting from subcutaneous epinephrine suspension injection.
abstract: A 32-year-old asthmatic man developed a life-threatening Clostridium perfringens infection after subcutaneous epinephrine suspension injection. Extensive surgical debridement, including forequarter amputation, hyperbaric oxygen therapy, and appropriate antibiotics were used as life-saving measures. The patient made a fair functional recovery. We could find no previously reported cases of gas gangrene following subcutaneous injection in otherwise healthy individuals. The pathogenesis and treatment of this infection are discussed.
authors.affiliation: Department of Emergency Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: L F
authors.initials: LF
authors.lastname: Hallagan
authors.forename: J L
authors.initials: JL
authors.lastname: Scott
authors.forename: B C
authors.initials: BC
authors.lastname: Horowitz
authors.forename: C F
authors.initials: CF
authors.lastname: Feied
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003016:Clostridium perfringens / Q000302:isolation & purification; D003646:Debridement; D004837:Epinephrine / Q000009:adverse effects*; D005738:Gas Gangrene / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D007279:Injections, Subcutaneous; D008297:Male
chemical_list: D000900:Anti-Bacterial Agents; D004837:Epinephrine