Fernandez R J, Gluck J L
University of Kansas School of Medicine--Wichita.
Clin Orthop Relat Res. 1994 Nov(308):178-82.
Clostridial myonecrosis is a complication associated with contaminated traumatized wounds. Presented is the case of an elderly female with pain in her right hip, radiographic evidence of gas in the soft tissues, and no history of trauma. Evaluation of this patient revealed Clostridial myonecrosis. Culture results identified the organism as Clostridium septicum. Due to the association between Clostridium septicum and occult malignancies, colonoscopic evaluation was performed. A colonic lesion was discovered, biopsied, resected, and staged, using the Modified Duke Classification, as a well differentiated adenocarcinoma, C2 lesion. Myonecrosis and its associated malignancies carry high morbidity and mortality, but early diagnosis, appropriate treatment, and awareness of the association with occult malignancies may avert unnecessary mortality.
梭菌性肌坏死是一种与创伤伤口污染相关的并发症。本文介绍了一例老年女性病例,该患者右髋部疼痛,影像学检查显示软组织中有气体,但无创伤史。对该患者的评估显示为梭菌性肌坏死。培养结果确定病原体为败血梭菌。由于败血梭菌与隐匿性恶性肿瘤之间的关联,对患者进行了结肠镜检查。发现了一个结肠病变,进行了活检、切除,并根据改良杜克分类法分期为高分化腺癌,C2期病变。肌坏死及其相关的恶性肿瘤具有很高的发病率和死亡率,但早期诊断、适当治疗以及对与隐匿性恶性肿瘤关联的认识可能避免不必要的死亡。