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. 2022 Apr;104(4):e95-e97.
doi: 10.1308/rcsann.2021.0153. Epub 2021 Nov 26.

Atraumatic Clostridium septicum myonecrosis presenting as upper limb ischaemia in a patient with undiagnosed bowel cancer

S Bickerton  1 , A Awopetu  1 , A Abood  1 , H Lee  1 , Tra Lane  1 , Awn Reid  1
Affiliations

Atraumatic Clostridium septicum myonecrosis presenting as upper limb ischaemia in a patient with undiagnosed bowel cancer

S Bickerton et al. Ann R Coll Surg Engl. 2022 Apr.

Abstract

Necrotising infections remain challenging to surgeons, both in diagnosis and management. Timely recognition and treatment remain vital. We report a presentation of limb ischaemia with no apparent precipitating factors, in a systemically stable patient, due to atraumatic Clostridium septicum myonecrosis. This article demonstrates the use of rapid cross-sectional imaging in finding an undiagnosed bowel cancer as a basis for this type of infection. Rapid cross-sectional imaging may be utilised where there is doubt about the underlying pathology of upper limb ischaemia. Patients whose cultures grow Clostridium septicum must be investigated for malignancy.

Keywords: Cancer; Clostridial; Limb ischaemia; Myonecrosis; Necrotising.

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Figures

Figure 1
Figure 1
Ischaemic left upper limb on presentation
Figure 2
Figure 2
(a) Axial computed tomography image of gas within muscle compartments extending onto the chest wall. (b) Caecal lesion. (c) Right lung nodules.
Figure 3
Figure 3
Pre-procedure photograph demonstrating clear delineation of skin discolouration
See this image and copyright information in PMC

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