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Spontaneous Occurrence of Gangrene Due to Clostridium septicum in a Patient With Advanced Endometrial Carcinoma

Moore, David H. (Department of Obstetrics and Gynecology, Indiana University Medical Center, 550 North University Boulevard, UH #2440, Indianapolis 46202-5274, IN, USA ) ; Ghosh, Kris (Department of Obstetrics and Gynecology, Indiana University Medical Center, 550 North University Boulevard, UH #2440, Indianapolis 46202-5274, IN, USA ) ; Sutton, Gregory P. (Department of Obstetrics and Gynecology, Indiana University Medical Center, 550 North University Boulevard, UH #2440, Indianapolis 46202-5274, IN, USA ) ;
  • 초록  

    Background: We report the first known case of spontaneous, atraumatic Clostridium septicum gangrene occurring in a patient with recurrent endometrial adenocarcinoma. Case: A 63-year-old white female undergoing chemotherapy for recurrent endometrial adenocarcinoma presented with right “arthritis-like” shoulder pain. She denied fever, chills, or shoulder trauma. The patient was afebrile and her blood pressure was 100/50. Her right shoulder and upper extremity were remarkable for an area of dark blue discoloration with crepitus. The white blood cell (WBC) count was 8,200/μl with left shift. Serum creatinine, platelet count, and coagulation studies were normal. Computed tomography revealed gas in the right shoulder tissues. A Gram stain of fluid aspirated from the shoulder demonstrated gram-positive spore-forming rods. She declined surgical intervention and expired within hours of admission. Cultures of the right shoulder eventually grew Clostridium septicum. Conclusion: It is imperative to consider clostridial gangrene in the differential diagnosis for any patient with cancer and a fever of unknown origin.


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