Extensive clostridial myonecrosis after gluteal intramuscular injection in immunocompromised patient treated with surgical debridement and negative-pressure wound therapy
- Resource Type
- Authors
- Jakov Mihanović; Ivan Bačić; Robert Karlo; Antoine Counil; Laurine Paquier; Boris Dželalija
- Source
- Trauma Case Reports, Vol 32, Iss, Pp 100469-(2021)
Trauma Case Reports
- Subject
- medicine.medical_specialty
RD1-811
medicine.medical_treatment
Case Report
Critical Care and Intensive Care Medicine
Anaerobic infection
Sepsis
03 medical and health sciences
0302 clinical medicine
Negative-pressure wound therapy
medicine
Orthopedics and Sports Medicine
Clostridum perfringens
Infectious disease (athletes)
Adverse effect
030222 orthopedics
Clostridum perfringens Gas gangrene Intramuscular injections Negative-pressure wound therapy Steroids Immunosuppressio
business.industry
030208 emergency & critical care medicine
Immunosuppression
medicine.disease
Intramuscular injections
Surgery
Emergency Medicine
Steroids
Gas gangrene
Intramuscular injection
business
- Language
- English
- ISSN
- 2352-6440
Gas gangrene is infectious disease caused by Clostridium perfringens infection. We are presenting extremely rare case of gluteal clostridial myonecrosis after intramuscular injection of diclofenac in immunocompromised young patient on a long-standing corticosteroid therapy presented with sepsis and initially absent clinical signs of severe anaerobic infection. After delayed diagnosis, she was treated with aggressive surgical removal of necrosed tissue and targeted antibiotic therapy which led to a rapid improvement allowing application of a negative- pressure wound therapy device with favorable outcome. This report shows the importance of timely diagnosis with pitfalls of imaging. It confirms that surgical debridement along with specific antibiotic therapy is the mainstay of treatment, but also promotes negative-pressure wound therapy which has proved convenient for accelerated closure of large incisions with tissue loss without any adverse effects or the need for complex recon-structive procedures.