ABSTRACT
Clostridial gas gangrene of the abdominal wall is rare, and it is usually associated with organ perforation, immunosuppression or gastrointestinal malignancies. In this paper, we present a case of fulminant, endogenous gas gangrene in a 58-year old diabetic female with arterial hypertension and atherosclerosis, following uneventful laparoscopic cholecystectomy. She developed gas gangrene of the abdominal wall 12-hours after cholecystectomy and died 24-hours after the onset of the first symptoms, in spite oftreatment.
La gangrena gaseosa clostridial de la pared abdominal es rara, y normalmente se halla asociada con la perforación de órganos, inmunosupresión o malignidades gastrointestinales. En este trabajo, se presenta un caso de gangrena gaseosa endógena fulminante en una mujer diabética de 58 años con hipertensión arterial y ateroesclerosis, tras una colecistectomía laparoscópica sin incidentes. Doce horas después de la colecistectomía, la mujer desarrolló una gangrena gaseosa de la pared abdominal, y murió 24 horas después del comienzo de los primeros síntomas, a pesar del tratamiento.
Subject(s)
Female , Humans , Middle Aged , Abdominal Wall/microbiology , Cholecystectomy, Laparoscopic/adverse effects , Clostridium Infections/diagnosis , Gas Gangrene/microbiology , Atherosclerosis/complications , Fatal Outcome , Hypertension/complicationsABSTRACT
Members of Bacteroidaceae family are the most commonly isolated anaerobic pathogens in humans. This study summarises our experience of isolation and antimicrobial susceptibility pattern of these anaerobes from diverse clinical infections in a tertiary care hospital. Over a period of 5 years, 611 samples were received for anaerobic culture. Of these, 53 specimens yielded 62 anaerobic isolates. Thirty of the 62 isolates (48.4%) belonged to Bacteroidacea family obtained from 29 patients. They comprised of 14 (14/32; 43.7%) Prevotella spp., 13 (13/32; 40.6%) Bacteroides spp., 3 (3/32; 9.3%) Porphyromonas spp and Fusobacterium (2/32; 6.2%). In 14 of 27 patients (48%) the infection was polymicrobial. All the isolated strains were sensitive to metronidazole. This study highlights need for adopting anaerobic culture technique as a routine diagnostic procedure and constant monitoring of antimicrobial susceptibility of all anaerobic isolates.
Subject(s)
Bacteremia/microbiology , Bacteroidaceae/isolation & purification , Gas Gangrene/microbiology , Humans , Tooth Diseases/microbiologyABSTRACT
A Gangrena Gasosa é uma doença infecciosa de ocorrênica näo muito rara e, devido a suas características, é importante que o médico tenha conhecimento e esteja atento quanto às suas características clínicas, de modo a facilitar o diagnóstico e a diferenciaçäo entre as formas clostridial e näo clostridial, o que determina diferentes abordagens terapêuticas. Säo considerados fatores etiológicos, formas clínicas e modalidades de tratamento
Subject(s)
Humans , Male , Adolescent , Gas Gangrene/microbiology , Bacterial Infections , Gas Gangrene/diagnosis , Gas Gangrene/therapy , Hyperbaric OxygenationABSTRACT
Se comunican 9 enfermos con cultivo anaerobio positivo para Clostridium perfringens y uno para Clostridium novyi. Cinco correspondieron clínicamente a gangrena gaseosa, en relación con cirugía u otro tipo de traumatismo. Se destaca como elemento de mal pronóstico la diabetes, paciente de mayor edad, cirugía previa y localización en una zona que dificulte la realización de cirugía radical. La letalidad general fue de un 60 por ciento. El manejo adecuado de estos pacientes requiere cirugía radical, precoz y una asociación de antibióticos que incluya Penicilina y Cloramfenicol por vía intravenosa y en altas dosis