title: Clostridium septicum can cause distant myonecrosis in patients with ovarian cancer.
abstract: A case report of lethal distant myonecrosis with gas gangrene is presented. Blood cultures and tissue biopsies revealed Clostridium septicum. The 55-year-old female patient presented with recurrent ovarian cancer of transitional cell type, initially diagnosed as FIGO IIb in January 2011, with hepatic metastasis and invasion of the ceacal wall. She underwent several operations, including partial bowel and liver resection in September 2011. Second-line therapy with topotecan three weekly was started in October 2011 while the patient was still in the hospital. During this chemotherapy, the patient revealed symptoms of severe pain and erythema of the skin. Within hours she died of sceptic shock after a debridement. The diagnosis was gas gangrene due to Clostridium septicum. Because it is a rare and severe disease and the time slot in which therapeutic measures can be taken is narrow, we discuss clinical symptoms and therapeutic options.
authors.affiliation: Department of Gynecological Oncology, [corrected] Campus Virchow Hospital, Berlin, Germany. sarah.zurmeyer@charite.de
authors.forename: Sarah
authors.initials: S
authors.lastname: Zurmeyer
authors.forename: Christina
authors.initials: C
authors.lastname: Fotopoulou
authors.forename: Elena
authors.initials: E
authors.lastname: Braicu
authors.forename: Uwe
authors.initials: U
authors.lastname: Schlichting
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D052557:Clostridium septicum / Q000502:physiology; D003646:Debridement; D017809:Fatal Outcome; D005260:Female; D005738:Gas Gangrene / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000382:microbiology / Q000556:secondary; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology* / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000382:microbiology / Q000473:pathology