RESUMO
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.
Assuntos
Adenocarcinoma/complicações , Neoplasias do Colo/complicações , Gangrena Gasosa/complicações , Adenocarcinoma/cirurgia , Idoso , Idoso de 80 Anos ou mais , Nádegas , Clostridium/isolamento & purificação , Neoplasias do Colo/cirurgia , Feminino , Gangrena Gasosa/microbiologia , Gangrena Gasosa/patologia , Articulação do Quadril/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , RadiografiaRESUMO
We have described a patient with cryptococcemia due to Cryptococcus albidus. Although usually nonpathogenic, C albidus and other non-neoformans cryptococcal species may occasionally be the causative agents in severe infections in man. The latex agglutination test for cryptococcal polysaccharide capsular antigen appears to be specific for C neoformans and thus may be falsely negative in serious infections caused by non-neoformans cryptococci, as seen in our patient with C albidus fungemia. Severe infections caused by C albidus appear to respond to treatment with amphotericin B with or without 5-fluorocytosine but so few cases are available for analysis that no firm conclusions can be made in this regard at present.
