Table 1 Cases of limb preservation after treatment of gas gangrene (Clostridial myonecrosis)
From: Limb salvage after gas gangrene: a case report and review of the literature
Age/Gender/Reference | Comorbidity, Previous history | Localization/Cultures results | Clinical presentation | Antibiotics/Other treatment | Complications/Hospitalization (days)/Functional status |
|---|---|---|---|---|---|
35/M [Present case] | Intravenous drug user, Hepatitis C | Shoulder/C. perfrigens, Staph aureus, Staph epidermidis | Pain, fever, swelling, crepitus | Pip/Taz, Clind, Vanc → Meropenem/Skin grafting | Septic shock, myoglo-binuria, RF/120d/limited function |
54/M [10] | DM, cecal cancer | Arm/C septicum | 24 hr arm/abdominal pain, fever, nausea, vomiting, diarrhea, shoulder tenderness, induration, crepitus | Pip/Taz, Clind, Vanc | Anemia/NR/NR |
37/M [5] | Posttraumatic Head fracture | Shoulder/C perfrigens S epidermidis | shoulder pain, fever, agitation, crepitus | Vanc → Pen/Clind/Metr → Cefo, Metro → Pen/Metro → Metro p.os | Anosmia/40d/Normal |
26/M [9] | Intravenous drug user | Lower limb/C perfringens, Beta- Streptococci, enterococci | Suspected DVT, thigh/left iliac fossa tenderness | Pen, Clind, Metr/femoral artery vascular grafting | Femoral vein, artery and nerve erosion/126d/Mobile |
49/M [23] | Postoperative | Hand/C perfrigens C sordellii | 1st postoperative day pain/fever | Pen | -/21d/normal |
55/M [12] | DM, peripheral vascular disease, cecal mass | Hip/C septicum | Pain, fever, crepitus | Pip/Taz, Clind, Ceft→Pip/Taz, Clind | RF, myoglobinuria/NR/NR |
58/M [6] | Posttraumatic | Heel/ | Foot pain, fever, | Antibiotics, hyperbaric oxygen, Skin grafting | MOFS/78d/normal |
32/M [11] | Postoperative | Lower limb/C septicum | Pain, crepitus | NR | NR/NR/NR |
83/M [14] | Sciatica, pneumonia, colon cancer | Hip, thigh/C septicum | 3 days, hip pain, fever, nausea, vomiting | Vanc, Genta, Imip/Sil → Am/Cl/Right hemicolectomy | -/16d/ambulated with assistance |
47/M [4] | chronic pancreatitis, DM, pentazocin injection sites. | Thigh - buttock/C perfrigens | 6 day pain, swelling, fever, | Pen, Metr, polyvalent clostridial antitoxin,/Skin grafting | Respiratory failure,/NR/normal |
25/M [7] | Crush injury | Leg/C perfrigens | Pain, fever, limb discoloration, edema, crepitus | Cefalotin → Pen, hyperbaric oxygen/skin-bone grafting | -/180d/able to bare weight |
48/F [24] | Posttraumatic | Knee/C perfrigens | Pain, stiffness, tenderness | Terra → Pen, Gas gangrene serum | -/21d/normal |