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Case Reports
. 2018 Jun;54(6):e121-e123.
doi: 10.1016/j.jemermed.2018.01.036. Epub 2018 Mar 10.

Atraumatic Clostridial Myonecrosis in an Immunocompromised Host

Kristine M Thompson  1 , Brian T Kruse  1 , Mary Ann S Hedges  2
Affiliations
Case Reports

Atraumatic Clostridial Myonecrosis in an Immunocompromised Host

Kristine M Thompson et al. J Emerg Med. 2018 Jun.

Abstract

Background: Necrotizing 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 report: We 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.

Keywords: infections in immunocompromised patients; limb pain; necrotizing fasciitis; occult gastrointestinal cancer.

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