Turban Adrien, Joussellin Vincent, Piau Caroline, Cattoir Vincent, Launey Yoann, Eustache Gabriel
Department of Bacteriology, University Hospital of Rennes, 2 Rue Henri Le Guilloux, 35000 Rennes, France.
Critical Care Unit, Department of Anaesthesia, Critical Care and Perioperative Medicine, University Hospital of Rennes, Rennes, France.
Access Microbiol. 2024 Aug 5;6(8). doi: 10.1099/acmi.0.000825.v3. eCollection 2024.
gas gangrene is a severe and deadly infection caused by an anaerobic, spore-forming, Gram-positive bacillus. As previously described, two entities are observed: traumatic and spontaneous (or non-traumatic) forms. In this report, we aim to describe the case of a fulminant and ultimately fatal myonecrosis occurring in a patient who was first admitted for refractory cardiac arrest and placed on veino-arterial extracorporeal membrane oxygenation (ECMO). Building upon prior studies that have documented cases of spontaneous gas gangrene caused by , we provide an updated compilation, focusing on microbiological characteristics of , along with the diagnostic and therapeutic challenges associated with spontaneous gas gangrene. Additionally, the specific clinical situation of our case illustrates the seriousness of this infectious complication that combined both spontaneous and traumatic gas gangrene risk factors. We thus, discuss the antibiotic coverage prior to the initiation of ECMO procedure.
气性坏疽是由一种厌氧、产芽孢、革兰氏阳性杆菌引起的严重致命感染。如前所述，可观察到两种类型：创伤性和气性坏疽的自发（或非创伤性）形式。在本报告中，我们旨在描述一例暴发性并最终致命的肌坏死病例，该患者最初因难治性心脏骤停入院，并接受静脉-动脉体外膜肺氧合（ECMO）治疗。基于先前记录由[具体病原体未提及]引起的自发性气性坏疽病例的研究，我们提供了一份最新汇编，重点关注[具体病原体未提及]的微生物学特征，以及与自发性气性坏疽相关的诊断和治疗挑战。此外，我们病例的具体临床情况说明了这种感染性并发症的严重性，它同时具备自发性和气性坏疽的危险因素。因此，我们讨论了在启动ECMO程序之前的抗生素覆盖范围。
