Atraumatic Clostridial Myonecrosis in an Immunocompromised Host

Publication date: Available online 10 March 2018
Source:The Journal of Emergency Medicine
Author(s): Kristine M. Thompson, Brian T. Kruse, Mary Ann S. Hedges
BackgroundNecrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal cancer or immunocompromise, or both.Case ReportWe report a case of catastrophic atraumatic Clostridium septicum infection in an immunocompromised host.Why Should an Emergency Physician Be Aware of This?Emergency physicians most commonly associate necrotizing fasciitis with superinfection of an open wound. This case reminds physicians that patients with acquired neutropenia can present with spontaneous gas gangrene due to C. septicum. Providers should consider this diagnosis in immunocompromised patients who present with acute onset of severe atraumatic limb pain.



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