Massive gas gangrene secondary to occult colon carcinoma

Griffin, Andrew; Crawford, Matthew D.; Gupta, Rajan T.

doi:10.1016/j.radcr.2016.02.006

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…Over 83% (5/6) of patients who did undergo DRE demonstrated positive findings, including a palpable mass (4), purulent anal drainage (1), and pain out of proportion (1). This over 80% rate of positive findings on DRE is consistent with a study by the World Journal of Gastroenterology in 2015 which showed that preoperative DRE resulted in positive findings in 75% of FG with underlying rectal cancer and it highlights the importance of including a thorough anorectal examination in all patients with FG [1,3,[15][16][17].…”

Section: Diagnosissupporting

confidence: 65%

“…The antibiotic regimen should cover Staphylococcus, Enterococcus, Escherichia coli, and other Gram-negative pathogens and anaerobes (including Bacteroides and Clostridium species). Most commonly used agents include broad-spectrum penicillin with a beta-lactamase inhibitor, a second-or third-generation cephalosporin, a carbapenem, in combination with agents that cover potentially resistant Gram-positive bacteria and anaerobes, i.e., Vancomycin or Daptomycin, Clindamycin, and/or Metronidazole [5,6,14,16]. As soon as culture results are available, a targeted therapy should be implemented.…”

Section: Treatment and Prognosismentioning

confidence: 99%

See 1 more Smart Citation

Fournier’s Gangrene in the Setting of Underlying Carcinoma: A Case Report and Review of the Literature

Mann

Reinoso

Genuit

et al. 2020

Cureus

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Most case series of Fournier's gangrene (FG) do not list malignancy as a cause; however, isolated cases with underlying malignancy of the soft tissue, genitourinary, and gastrointestinal systems have been described. After a review of recently published literature, 20 case reports and 15 case series or review articles included relevant information and were included in this literature review. Malignancy is overlooked in 10% (2/20) of patients, resulting in a delayed diagnosis and initiation of cancer treatment. All patients with FG should have a thorough cancer history, digital rectal examination, appropriate local and systemic imaging, as well as tissue biopsies, to reduce the likelihood of a missed cancer diagnosis. Delay in management of the local malignancy may lead to persistence or recurrence of the infection and significantly worsens overall outcome and survival.

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Section: Diagnosissupporting

confidence: 65%

Section: Treatment and Prognosismentioning

confidence: 99%

Fournier’s Gangrene in the Setting of Underlying Carcinoma: A Case Report and Review of the Literature

Mann

Reinoso

Genuit

et al. 2020

Cureus

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“…Nontraumatic gas gangrene may be associated with colon cancer [31,32]. An 81-year-old female patient with rectal cancer became acutely ill with abdominal pain and paralytic ileus.…”

Section: Nontraumatic Gas Gangrenementioning

confidence: 99%

Pathology of Gangrene

Tsutsumi¹

2020

Pathogenic Bacteria

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Pathological features of gangrene are described. Gangrene is commonly caused by infection of anaerobic bacteria. Dry gangrene belongs to noninfectious gangrene. The hypoxic/ischemic condition accelerates the growth of anaerobic bacteria and extensive necrosis of the involved tissue. Clostridial and non-clostridial gangrene provokes gas formation in the necrotic tissue. Acute gangrenous inflammation happens in a variety of tissues and organs, including the vermiform appendix, gallbladder, bile duct, lung, and eyeball. Emphysematous (gas-forming) infection such as emphysematous pyelonephritis may be provoked by Escherichia coli and Klebsiella pneumoniae. Rapidly progressive gangrene of the extremities (so-called “flesh-eating bacteria” infection) is seen in fulminant streptococcal, Vibrio vulnificus, and Aeromonas hydrophila infections. Fournier gangrene is an aggressive and life-threatening gangrenous disease seen in the scrotum and rectum. Necrotizing fasciitis is a subacute form of gangrene of the extremities. Of note is the fact that clostridial and streptococcal infections in the internal organs may result in a lethal hypercytokinemic state without association of gangrene of the arms and legs. Uncontrolled diabetes mellitus may play an important role for vulnerability of the infectious diseases. Pseudomonas-induced malignant otitis externa and craniofacial mucormycosis are special forms of the lethal gangrenous disorder.

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“…septicum is the main etiological agent of spontaneous myonecrosis, even though infection can also manifest as fatal, necrotizing enterocolitis or distal ileitis [223][224][225][226][227][228][229]. It is not part of the normal human intestinal and stool flora [230,231] possibly is an opportunistic pathogen, but is part of the normal gastrointestinal microbiota of many animals [232,233].…”

Section: Septicum Toxinsmentioning

confidence: 99%

“…Diagnosis of spontaneous myonecrosis is difficult and the symptoms are result of an fast systemic infection [237]. Due to the low incidence of this infection, no preventive protocols have been developed, the most prone patients (for example immunosuppressed, with a history of gastric diseases) should undergo a preventive diagnosis, but that has not been implemented yet [227,229,238]. The work of Michael J. G. Mallozzi et al [239] show an excellent review of several aspects of the infection of C. septicum encompassing the diagnosis of the same.…”

Section: Septicum Toxinsmentioning

confidence: 99%