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Open Access 01-12-2011 | Review

Limb salvage after gas gangrene: a case report and review of the literature

Authors: John Aggelidakis, Konstantinos Lasithiotakis, Anastasia Topalidou, John Koutroumpas, Georgios Kouvidis, Paulos Katonis

Published in: World Journal of Emergency Surgery | Issue 1/2011

Abstract

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented.

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Bryant AE, Stevens DL: Clostridial myonecrosis: new insights in pathogenesis and management. Curr Infect Dis Rep. 2010, 12 (5): 383-91. 10.1007/s11908-010-0127-y.CrossRefPubMed

Bryan C: Gangrene bug killed 35 heroin users. WJM. 2000, 173: 82-83. 10.1136/ewjm.173.2.82.CrossRef

Stevens : Clostridial Myonecrosis and other Clostridial Diseases. Cecil Textbook of Medicine. Edited by: L Goldman, JC Bennett. 2000, Philadelphia: WB Saunders, chapter 334: 1668-1673. 21

Kershaw CJ, Bulstrode CJ: Gas gangrene in a diabetic after intramuscular injection. Postgrad Med J. 1988, 64: 812-3. 10.1136/pgmj.64.756.812.PubMedCentralCrossRefPubMed

Lanting B, Athwal GS, Naudie DD: Spontaneous Clostridium perfringens myonecrosis of the shoulder: a case report. Clin Orthop Relat Res. 2007, 461: 20-4.PubMed

Ferraù S, Sallusti R, Lozano Valdes A, Gonzales C, Jónsson M, Gunnlaugsson G, Gullo A: HBO and gas gangrene. A case report. Minerva Anestesiol. 2001, 67: 745-9.PubMed

Hoffman S, Katz JF, Jacobson JH: Salvage of a lower limb after gas gangrene. Bull N Y Acad Med. 1971, 47: 40-9.PubMedCentralPubMed

Pentazocine: Drug information. Edited by: Basow, DS. 2011, Waltham, MA, No authors listed. In: UpToDate 19.1,

Assadian O, Assadian A, Senekowitsch C, Makristathis A, Hagmüller G: Gas gangrene due to Clostridium perfringens in two injecting drug users in Vienna, Austria. Wien Klin Wochenschr. 2004, 116: 264-7. 10.1007/BF03041058.CrossRefPubMed

10.

Gibson M, Avgerinos D, Llaguna O, Sheth D: Myonecrosis secondary to Clostridium Septicum in a patient with occult colon malignancy: a case report. Cases Journal. 2008, 1: 300-10.1186/1757-1626-1-300.PubMedCentralCrossRefPubMed

11.

Larson CM, Bubrick MP, Jacobs DM, West MA: Malignancy, mortality, and medicosurgical management of Clostridium septicum infection. Surgery. 1995, 118: 592-7. 10.1016/S0039-6060(05)80023-6. discussion 597-8CrossRefPubMed

12.

Clay A, Behnia M: A 55-Year-Old Man With Fever, Renal Failure, and Hip Pain. Chest. 2001, 119: 281-284. 10.1378/chest.119.1.281.CrossRefPubMed

13.

Sudarsky LA, Laschinger JC, Coppa GF, Spencer FC: Improved results from a standardized approach in treating patients with necrotizing fasciitis. Ann Surg. 1987, 206: 661-5.PubMedCentralCrossRefPubMed

14.

Fernandez RJ, Gluck JL: Clostridium septicum gas gangrene of the gluteus maximus and an ascending colon malignant tumor. A case report. Clin Orthop Relat Res. 1994, 308: 178-82.PubMed

15.

Heck R: General Principles of Amputations. Campbell's Operative Orthopedics. Edited by: Canale ST, Beaty JH. 2008, Pensylvania: Mosby, Elsevier, 1: 562-566. 11

16.

Smith D: Amputations. Current diagnosis and treatment in orthopedics. Edited by: Skinner H. 2003, New York: Lange Medical Books/Mc Graw-Hill, 638-654. 3

17.

Lehner PJ, Powell H: Gas gangrene. BMJ. 1991, 303: 240-2. 10.1136/bmj.303.6796.240.PubMedCentralCrossRefPubMed

18.

Mercer N, Davies DM: Gas gangrene. BMJ. 1991, 303: 854-5.PubMedCentralCrossRefPubMed

19.

Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan EL, Montoya JG, Wade JC: Practice guidelines for the diagnosis and management of skin and soft-tissue infections. CID. 2005, 41: 1373-406. 10.1086/497143.CrossRef

20.

Norrby-Teglund A, Muller MP, McGeer A, Gan BS, Guru V, Bohnen J, Thulin P, Low DE: Successful management of severe group A streptococcal soft tissue infections using an aggressive medical regimen including intravenous polyspecific immunoglobulin together with a conservative surgical approach. Scand J Infect Dis. 2005, 37: 166-72.PubMed

21.

Tibbles PM, Edelsberg JS: Hyperbaric-oxygen therapy. N Engl J Med. 1996, 334: 1642-10.1056/NEJM199606203342506.CrossRefPubMed

22.

Demello FJ, Haglin JJ, Hitchcock CR: Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotics, surgery, and hyperbaric oxygen. Surgery. 1973, 73: 936-PubMed

23.

Lorea P, Baeten Y, Chahidi N, Franck D, Moermans JP: A severe complication of muscle transfer: clostridial myonecrosis. Ann Chir Plast Esthet. 2004, 49: 32-5. 10.1016/j.anplas.2003.12.010.CrossRefPubMed

24.

McNae J: An unusual case of Clostridium welchii infection. J Bone Joint Surg Br. 1966, 48: 512-3.PubMed

Title: Limb salvage after gas gangrene: a case report and review of the literature
Authors: John Aggelidakis
Konstantinos Lasithiotakis
Anastasia Topalidou
John Koutroumpas
Georgios Kouvidis
Paulos Katonis
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2011
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/1749-7922-6-28

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Limb salvage after gas gangrene: a case report and review of the literature

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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