Atraumatic Clostridial myonecrosis: case report and literature review.
Clostridial myonecrosis (CM) is a rare, life-threatening infection that is most often associated with recent surgery or skeletal muscle trauma. It usually affects patients with some degree of underlying immunocompromise or vascular insufficiency. Occasionally, CM can occur at remote sites, with seeding from a gastrointestinal source in the setting of malignancy. We report a case of a 75-year-old man who developed rapidly progressive myonecrosis in the right shoulder, without prior trauma, caused by Clostridium septicum. On autopsy, this patient was found to have previously undiagnosed radiation colitis with ulcerations and abscess formation, secondary to recent prostate cancer radiation therapy. Although several case reports discuss CM in the setting of bowel malignancy, our case illustrates that non-malignant bowel inflammation may be a sufficient source for the infection. Clinical features of this uncommon disease are discussed, and the relevant literature is reviewed with regard to Clostridium septicum as an etiologic agent.
Section of Emergency Medicine, University of Chicago Hospitals, Chicago, Illinois 60637, USA.
Benjamin S
BS
Abella
Paulina
P
Kuchinic
Toshi
T
Hiraoka
David S
DS
Howes
D000208:Acute Disease; D000368:Aged; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001132:Arm; D001768:Blister / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D003646:Debridement; D048909:Diabetes Complications; D004638:Emergency Treatment / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D009336:Necrosis; D012307:Risk Factors; D013997:Time Factors
D000900:Anti-Bacterial Agents