Rapidly Developing Gas Gangrene Due to a Simple Puncture Wound

Gas gangrene, an infection caused by Clostridium perfringens, is a potentially fatal and physically disabling disease due to its sometimes incredibly rapid progression.An adolescent boy was referred to our university hospital with a history of nail puncture in the hand that occurred a few hours prev...

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Bibliographic Details
Published in:	Pediatric emergency care Vol. 26; no. 6; pp. 434 - 435
Main Authors:	Öncel, Selim, Arsoy, Emin Sami
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-06-2010 Lippincott Williams & Wilkins
Subjects:	Adolescent Amputation Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Arm - surgery Biological and medical sciences Diagnosis, Differential Gas Gangrene - diagnosis Gas Gangrene - etiology Gas Gangrene - surgery General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Hand Injuries - etiology Humans Intensive care medicine Male Medical sciences Punctures Wounds, Penetrating - complications Human Intensive care Gas gangrene Clostridiales Wound Clostridium perfringens Infection puncture wound Clostridiaceae Bacteriosis Bacteria Child Resuscitation
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Summary:	Gas gangrene, an infection caused by Clostridium perfringens, is a potentially fatal and physically disabling disease due to its sometimes incredibly rapid progression.An adolescent boy was referred to our university hospital with a history of nail puncture in the hand that occurred a few hours previously. The physical examination revealed a swollen and tender arm with crepitations up to the shoulder. Gas was coming out from the puncture wound with digital pressure on the forearm. The plain radiograph of the arm was typical of gas gangrene with the presence of gas under the skin and between muscular fibrils.Having received 1 dose of meropenem, the boy had surgery, in which his entire upper extremity had to be disarticulated from the shoulder. The maintenance antimicrobial therapy with intravenously administered penicillin G and clindamycin was continued for a duration of 10 days, at the end of which, the patient was discharged.The rapidly progressive character and the dramatic ending of this case made us wonder whether antimicrobial prophylaxis would play any role in the preventive management of puncture wounds.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0749-5161 1535-1815
DOI:	10.1097/PEC.0b013e3181e15e4f