Non-traumatic clostridial myositis: an unusual feature of brain death

Thys, Jean-Pierre; Ectors, P; Noël, Philippe

doi:10.1136/pgmj.56.657.501

Cited by 10 publications

(1 citation statement)

References 13 publications

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“…Clostridium perfringens is the most common organism isolated from patients with gas gangrene [3,6]. Other Clostridium species identified as causative organisms of the disease include C. septicum, C. novyi, and C. sordellii [1,4,18,19,21,25,27].…”

Section: Introductionmentioning

confidence: 99%

Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases

et al. 2007

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We prospectively investigated six fatal cases of clostridial gas gangrene using autopsy, histology, immunohistochemistry, microbiology, and scanning electron microscopy. The causative pathogen was Clostridium perfringens in four cases, C. sordellii in one case, and a mixed infection with both C. perfringens and C. sordellii in one case. According to the previous medical history and autopsy findings, clostridial infection was related to trauma in three cases. Characterized by extensive tissue necrosis and total absence of an accompanying leukocyte infiltration and tissue inflammatory response, the histopathological picture of clostridial gas gangrene is distinctly different from other bacterial infections. In medicolegal casework, the proof of the source of infection and the portal of entry of the responsible pathogen is not always an easy task, especially in the absence of trauma.

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Section: Introductionmentioning

confidence: 99%

Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases

et al. 2007

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Infektionskrankheiten

Ehrlich-Treuenstätt¹,

Gmelin²,

Kommerell³

et al. 1981

Verhandlungen Der Deutschen Gesellschaft Für Innere Medizin

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Carcinoma of the large intestine and nontraumatic, metastatic, clostridial myonecrosis

Furste

Dolor

Rothstein

et al. 1986

Diseases of the Colon &Amp; Rectum

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Traumatic, clostridial myonecrosis is a rare and serious complication of wounds. Nontraumatic, metastatic, clostridial myonecrosis may be caused by carcinoma of the large intestine. Nontraumatic myonecrosis becomes evident with localized pain, generalized toxicity, local signs of inflammation, and crepitation. Serum creatine kinase determinations may be of help in diagnosing patients suspected of having acute myonecrosis. Immediate heroic surgical intervention, usually with demonstration of Clostridium septicum, is mandatory to control the myonecrosis. Appropriate antibiotic therapy is a valuable adjunct to surgical intervention, and penicillin in massive doses appears to be the agent of choice for the clostridia. Hyperbaric oxygen therapy may help in the optimal control. General supportive measures, including frequent blood transfusions, are most important. To save the life of the patient with nontraumatic, metastatic, clostridial myonecrosis, it is necessary, as soon as the patient's general condition permits, to diagnose and eliminate the cause of the myonecrosis. In addition to the case reported, 16 cases have been reported in the literature, making a total of 17. Five patients have survived (survival rate, 29 percent).

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Non-traumatic clostridial myositis: an unusual feature of brain death

Cited by 10 publications

References 13 publications

Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases

Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases

Infektionskrankheiten

Carcinoma of the large intestine and nontraumatic, metastatic, clostridial myonecrosis

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