Takeyama M, Mori H, Nagareda T, Kuroda H, Yamane T, Matsumoto K, Terada N, Terai C, Nishide K
Acta Pathol Jpn. 1986 May;36(5):757-64. doi: 10.1111/j.1440-1827.1986.tb01063.x.
An autopsy case of clostridial gas gangrene occurring in a 54-year-old man with colon adenocarcinoma, liver cirrhosis, and diabetes mellitus is reported. The patient died 4 days after the onset of symptoms with episodes of vomiting and abdominal pain. Gangrene of both hips and perineum, hemolysis, renal failure, and disseminated intravascular coagulation were the dominant clinical features. Clostridium septicum was isolated from the subcutaneous tissue fluid. Adenocarcinoma of the ascending colon with ulceration found at autopsy was supposed to be an entry of the organism. Histologically, lesions of subcutaneous tissue and muscles were characterized by the absence of inflammatory infiltrates in spite of extensive necrosis. A summary of 35 cases of gas gangrene hospitalized to the Osaka University Hospital for the past 16 years indicates that clostridial gas gangrene patients with underlying diseases such as malignant neoplasm, diabetes, liver cirrhosis or immunodeficiency have a relatively poor prognosis.
报告了一例发生在一名54岁男性身上的梭菌性气性坏疽尸检病例，该患者患有结肠腺癌、肝硬化和糖尿病。患者在出现呕吐和腹痛症状4天后死亡。双髋和会阴坏疽、溶血、肾衰竭和弥散性血管内凝血是主要临床特征。从皮下组织液中分离出败血梭菌。尸检发现升结肠腺癌伴溃疡，推测为该病菌的侵入途径。组织学上，皮下组织和肌肉病变的特征是尽管有广泛坏死，但无炎性浸润。对大阪大学医院过去16年收治的35例气性坏疽病例的总结表明，患有恶性肿瘤、糖尿病、肝硬化或免疫缺陷等基础疾病的梭菌性气性坏疽患者预后相对较差。
