Foudroyant Course of an ExtensiveClostridium septicumGas Gangrene in a Diabetic Patient with Occult Carcinoma of the Colon

Author:

Hartel Maximilian1ORCID,Kutup Asad2,Gehl Axel3,Zustin Jozef4,Grossterlinden Lars G.1ORCID,Rueger Johannes M.1,Lehmann Wolfgang1

Affiliation:

1. Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany

2. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, MartiniStraße 52, 20246 Hamburg, Germany

3. Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany

4. Institute of Pathology, University Medical Center Hamburg-Eppendorf, MartiniStraße 52, 20246 Hamburg, Germany

Abstract

Background. Spontaneous gas gangrene is a rare disease in whichClostridium septicumfrequently can be detected. After an incubation period of 5–48 hours, a very painful swelling is accompanied by a rapidly spreading toxic-infectious clinical picture ultimately leading to septic shock and multiple organ failure. We present a case of a completely documented rare infectious disease with triage findings including initial vital signs, initial medical findings, and the emergency lab., radiological, intraoperative, histopathological, microbiological, and postmortem results. After initial diagnosis of the underlying disease, the patient has been immediately transferred to the operating theatre. The laboratory findings reflect the devastating effect of toxinαwhich is a toxin typically produced byC. septicum.The patient presented both an anaemia and a manifest coagulopathy as well as an onset of multiple organ failure. Despite the aggressive medical and surgical measures that have been taken, this patient could not be saved.Discussion. The case presented vividly emphasises the difficulty to identify these cases early enough to save a patient. This documentation may help health care providers to identify this life threatening disease as early as possible in future cases.

Publisher

Hindawi Limited

Subject

General Earth and Planetary Sciences,General Environmental Science

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