title: Clostridium perfringens infection of an anterior iliac crest bone graft donor site. A case report.
abstract: Postoperative infection of elective surgical wounds with Clostridium species has been linked to gastrointestinal tract lesions. A 55-year-old man with a history of peptic ulcer disease was treated by open reduction and internal fixation with autogeneic cancellous bone grafting from an anterior iliac crest donor site for nonunion of the clavicle. A mild serosanguinous drainage from the Penrose drain site at the iliac crest had ceased on postoperative Day 11; the patient complained of pain and a brownish drainage on postoperative Day 15. The infection was documented with cultures positive for Clostridium perfringens. Aggressive emergent surgical and antibiotic therapy resulted in complete clinical recovery. The wound infection did not advance to severe tissue damage and myonecrosis. This case represents the first reported infection of an iliac crest bone graft site with C. perfringens.
authors.affiliation: Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689.
authors.forename: S D
authors.initials: SD
authors.lastname: Miller
authors.forename: B R
authors.initials: BR
authors.lastname: Moed
authors.forename: J L
authors.initials: JL
authors.lastname: Chess
mesh_terms: D016025:Bone Transplantation; D002968:Clavicle / Q000293:injuries; D003015:Clostridium Infections / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D003016:Clostridium perfringens / Q000302:isolation & purification*; D005596:Fractures, Closed / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy