Gas gangrene with ulcerative colitis under immunosuppressive therapy: report of a case

• Published in: Zentralblatt für Chirurgie Vol. 131; no. 1; p. 84
• Main Authors: Jackisch, T, Freitag, M, Ludwig, K
• Format: Journal Article
• Language: German
• Published: Germany 01.02.2006
• Subjects: Adult; Amputation; Buttocks - pathology; Buttocks - surgery; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - immunology; Colitis, Ulcerative - pathology; Debridement; Diagnosis, Differential; Fatal Outcome; Gas Gangrene - immunology; Gas Gangrene - pathology; Gas Gangrene - surgery; Humans; Hydrocortisone - administration & dosage; Hydrocortisone - adverse effects; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Male; Multiple Organ Failure - immunology; Multiple Organ Failure - pathology; Multiple Organ Failure - surgery; Muscle, Skeletal - pathology; Muscle, Skeletal - surgery; Necrosis; Opportunistic Infections - immunology; Opportunistic Infections - pathology; Opportunistic Infections - surgery; Prednisolone - administration & dosage; Prednisolone - adverse effects; Psoas Abscess - pathology; Psoas Abscess - surgery; Reoperation; Thigh - pathology; Thigh - surgery
• ISSN: 0044-409X
• DOI: 10.1055/s-2006-921399

We report on a 30-year-old male with ulcerative colitis who developed a spontaneous gas gangrene in the right limb, the gluteal muscles and the retroperitoneal region under immunosuppressive therapy. In spite of immediate aggressive surgical and antibiotic therapy the massive infection led to septicemia and ultimately death. Clostridium septicum was identified with multiple local manifestations in the skeletal muscles. Gas gangrene is extremely rare in patients with ulcerative colitis or Crohn's disease and immunosuppression. The therapeutic options are discussed and the relevant present literature is reviewed.