Infect Chemother.  2014 Sep;46(3):199-203. 10.3947/ic.2014.46.3.199.

A Fatal Spontaneous Gas Gangrene due to Clostridium perfringens during Neutropenia of Allogeneic Stem Cell Transplantation: Case Report and Literature Review

• Lee HL
• Cho SY
• Lee DG
• Ko Y
• Hyun JI
• Kim BK
• Seo JH
• Lee JW
• Lee S

• KMID: 2284978
• DOI: http://doi.org/10.3947/ic.2014.46.3.199

Abstract

Most cases of gas gangrene caused by Clostridium species begin with trauma-related injuries but in rare cases, spontaneous gas gangrene (SGG) can occur when patients have conditions such as advanced malignancy, diabetes, or immunosuppression. Clostridium perfringens, a rare cause of SGG, exists as normal flora of skin and intestines of human. Adequate antibiotics with surgical debridement of infected tissue is the only curative therapeutic management. Mortality rate among adults is reported range of 67-100% and majority of deaths are occurred within 24 hours of onset. We experienced a case of SGG on the trunk, buttock and thigh in a neutropenic patient with acute lymphoblastic leukemia. His clinical course was rapid and fatal during pre-engraftment neutropenic period of allogeneic stem cell transplantation.

Keyword

Gas Gangrene; Clostridium perfringens; Neutropenia; Stem Cell Transplantation

MeSH Terms

Adult
Anti-Bacterial Agents
Buttocks
Clostridium
Clostridium perfringens*
Debridement
Gas Gangrene*
Humans
Immunosuppression
Intestines
Mortality
Neutropenia*
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Skin
Stem Cell Transplantation*
Thigh
Anti-Bacterial Agents

Figure

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  Figure 1 Chest X-ray shows soft tissue swelling on the left chest wall with internal air density.

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  Figure 2 Computed tomography of chest and abdomen. Subcutaneous emphysema on (A) the left chest wall (arrow) and (B) left trunk (arrow).

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