Ray D, Cohle S D, Lamb P
Department of Emergency Medicine, Butterworth Hospital, Grand Rapids, MI.
J Forensic Sci. 1992 Sep;37(5):1428-32.
Spontaneous, nontraumatic clostridial myonecrosis is a rare infection with an insidious onset and usually fatal outcome. Spontaneous clostridial myonecrosis has a frequent association with colon carcinoma, leukemia, diabetes mellitus, and drug-induced immunosuppression. We present the case of a 73-year-old diabetic man who died of spontaneous Clostridium septicum myonecrosis, who had presented with fulminant gangrene of the right thigh. Clostridium septicum was cultured from the quadriceps muscle postmortem. At autopsy, in addition to the gangrene, there was a Duke's A adenocarcinoma of the cecum, which had not been diagnosed during life. When spontaneous nontraumatic clostridial myonecrosis is diagnosed at autopsy, investigation should include through exam and the obtaining of past medical history in order to elucidate predisposing factors.
自发性非创伤性梭菌性肌坏死是一种罕见的感染，起病隐匿，通常预后不良。自发性梭菌性肌坏死常与结肠癌、白血病、糖尿病和药物性免疫抑制有关。我们报告一例73岁糖尿病男性患者，因自发性败血梭菌性肌坏死死亡，该患者表现为右大腿暴发性坏疽。死后从股四头肌培养出败血梭菌。尸检时，除坏疽外，还有盲肠杜克A期腺癌，生前未被诊断出。当尸检诊断出自发性非创伤性梭菌性肌坏死时，调查应包括全面检查和获取既往病史，以阐明易感因素。
