[Gas gangrene with ulcerative colitis under immunosuppressive therapy: report of a case].
We report on a 30-year-old male with ulcerative colitis who developed a spontaneous gas gangrene in the right limb, the gluteal muscles and the retroperitoneal region under immunosuppressive therapy. In spite of immediate aggressive surgical and antibiotic therapy the massive infection led to septicemia and ultimately death. Clostridium septicum was identified with multiple local manifestations in the skeletal muscles. Gas gangrene is extremely rare in patients with ulcerative colitis or Crohn's disease and immunosuppression. The therapeutic options are discussed and the relevant present literature is reviewed.
Klinik für Allgemein- und Abdominalchirurgie, Krankenhaus Dresden-Friedrichstadt, Akademisches Lehrkrankenhaus der TU Dresden, Friedrichstrasse 41, 02067 Dresden. jackisch-th@khdf.de
T
T
Jackisch
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M
Freitag
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K
Ludwig
D000328:Adult; D000671:Amputation, Surgical; D002081:Buttocks / Q000473:pathology / Q000601:surgery; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D003646:Debridement; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005738:Gas Gangrene / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009102:Multiple Organ Failure / Q000276:immunology / Q000473:pathology / Q000601:surgery; D018482:Muscle, Skeletal / Q000473:pathology / Q000601:surgery*; D009336:Necrosis; D009894:Opportunistic Infections / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D016659:Psoas Abscess / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D013848:Thigh / Q000473:pathology / Q000601:surgery
D007166:Immunosuppressive Agents; D011239:Prednisolone; D006854:Hydrocortisone