Nonclostridial gas gangrene: late infection after hip pinning.

An 86-year-old diabetic man had a late, gas-forming infection about Knowles pins. Although blood cultures were negative, a urinary tract infection followed by infection with the same organism in bone, muscle, and lung strongly supports hematogenous spread of E coli from the genitourinary system in this patient. The genitourinary system is well recognized as a source of bacteremia, and the skeletal system is the most often affected distant tissue when this occurs. A hematogenous cause of nonclostridial gas gangrene about an implant has not previously been reported.