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Nontraumatic Clostridium septicum Myonecrosis in Adults

Case Report and a 15-Year Systematic Literature Review

Forrester, Joseph D. MD, MSc; Shkolyar, Eugene MD; Gregg, David MD; Spain, David A. MD; Weiser, Thomas G. MD, MPH

Infectious Diseases in Clinical Practice: November 2016 - Volume 24 - Issue 6 - p 318–323
doi: 10.1097/IPC.0000000000000400
Review Articles

Clostridium septicum is a spore-forming anaerobic gram-positive rod capable of causing rapidly progressive nontraumatic myonecrosis. A case of nontraumatic C. septicum myonecrosis (ntCSM) is described. A systematic review of all published cases of ntCSM from 2000–2015 was performed. Twenty-three cases of ntCSM were identified. The median age was 67 years (range, 26–84 years) and 15 (68%) were men. Only 5 (21%) patients had multifocal disease. Diabetes mellitus was the most common preexisting medical condition present in 9 (39%) patients. Occult colon cancer was frequently associated with ntCSM and most commonly right-sided colon cancer (69%). Only 10 (42%) patients survived. Clostridium septicum myonecrosis is a surgical emergency associated with morbidity and mortality. Rapid and aggressive debridement remains the cornerstone of care, although mortality has changed little in the last 30 years, suggesting an opportunity for improving diagnosis, treatment, or both.

From the Departments of *Surgery and †Urology, Stanford University, Stanford, CA.

Correspondence to: Joseph D. Forrester, Department of Surgery, 300 Pasteur Dr, H3591, Stanford, CA 94305. E-mail:

The authors have no funding or conflicts of interest to disclose.

J.F. and E.S. each contributed equally to the work.

Consent: Consent was obtained from the patient for publishing this case report.

The views expressed in this manuscript are those of the authors and do not necessarily represent their affiliated institutions.

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