Spontaneous Occurrence of Gangrene Due toClostridium septicumin a Patient With AdvancedEndometrial Carcinoma

[摘要] Background:We report the first known case of spontaneous, atraumaticClostridium septicumgangrene 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 herblood pressure was 100/50. Her right shoulder and upper extremity were remarkable for an area of dark bluediscoloration 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 Gramstain 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 grewClostridiumsepticum.Conclusion:It is imperative to consider clostridial gangrene in the differential diagnosis for anypatient with cancer and a fever of unknown origin.

[学科分类] 妇产科学