Chapter 135. Gas Gangrene and Other Clostridial Infections (Part 3)
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Spontaneous nontraumatic clostridial myonecrosis (gas gangrene). A man in his 50s presented with severe pain in the right upper extremity. Over several hours, he developed progressive swelling and discoloration in that extremity (A), with hemorrhagic ecchymoses and bullae (B). Gram's stain of aspirate from bullous lesions revealed gram-positive bacilli (C). The patient underwent amputation of the extremity. Tissue Gram's stain (D) also showed gram-positive bacilli, and surgical cultures grew C. septicum. Subsequent evaluation of the patient led to the diagnosis of invasive colonic carcinoma. (Images used with permission of Stephen Calderwood, MD, and www.idimages.org.) Clostridia have been isolated from suppurative infections...
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