Iatrogenic Infection of Clostridium welchii Following Intramuscular Injection of Sodium Diclofenac

Sathyanarayana, Hemavathi; Rani, Leela; Rajendran, R; Sarmah, Pooja

doi:10.4103/0974-2727.115924

Cited by 4 publications

(3 citation statements)

References 4 publications

(7 reference statements)

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“…Our case shows efficiency of NPWT on large wound with significant tissue loss, allowing gradual closure in a short time period without the need for skin grafting. Literature search reveals several cases of gas gangrene caused by administration of various drugs via different parenteral routes such as intraarticular, intramuscular and intravenous [ [6] , [7] , [8] , [9] , [10] ]. Applied drugs (steroids, diclofenac, NSAID, crystalloids, vitamin B) do not have common denominator.…”

Section: Discussionmentioning

confidence: 99%

Extensive clostridial myonecrosis after gluteal intramuscular injection in immunocompromised patient treated with surgical debridement and negative-pressure wound therapy

Paquier

Mihanović

Counil

et al. 2021

Trauma Case Reports

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Gas gangrene is infectious disease caused by Clostridium perfringens infection. We are presenting extremely rare case of gluteal clostridial myonecrosis after intramuscular injection of diclofenac in immunocompromised young patient on a long-standing corticosteroid therapy presented with sepsis and initially absent clinical signs of severe anaerobic infection. After delayed diagnosis, she was treated with aggressive surgical removal of necrosed tissue and targeted antibiotic therapy which led to a rapid improvement allowing application of a negative-pressure wound therapy device with favorable outcome. This report shows the importance of timely diagnosis with pitfalls of imaging. It confirms that surgical debridement along with specific antibiotic therapy is the mainstay of treatment, but also promotes negative-pressure wound therapy which has proved convenient for accelerated closure of large incisions with tissue loss without any adverse effects or the need for complex reconstructive procedures.

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Section: Discussionmentioning

confidence: 99%

Extensive clostridial myonecrosis after gluteal intramuscular injection in immunocompromised patient treated with surgical debridement and negative-pressure wound therapy

Paquier

Mihanović

Counil

et al. 2021

Trauma Case Reports

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“…Factors favouring gas gangrene are trauma with large muscle involvement (e.g. burns, crush injuries, open fractures), following intramuscular injections 4 and wound contamination with dirt or shrapnel. Klebsiella is a non-capsulated Gram-negative bacillus, abundantly present in soil, water, fruits and vegetables grown close to the ground.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic non-clostridial gas gangrene – a case report

Jayanth

Ramkumar

2015

Med Leg J

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Skin and soft tissue infections of the lower limbs are quite common and can at times progress rapidly to become both limb and life-threatening infections. Muscular infections usually occur in areas of the body that have been compromised or injured by a foreign body, trauma, ischaemia, injection of illicit drugs, malignancy or surgery. Gas gangrene is one such limb-threatening infection. The gas-forming infection can be clostridial or non-clostridial. Clostridia are the main causative organism of the gas gangrene. Non-clostridial gas gangrene is a rare condition and is known to be associated with high mortality. Here, we report one such rare case where a middle-aged man succumbed to non-clostridial gas gangrene after he was administered an intramuscular injection. The case was registered as a suspicious death by the police and the body was subjected to medico legal autopsy.

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“…Systemic antiinflammatory effect of DS and other NSAIDs may lead to spreading the infection. [5,6,10] Out of the present 9 cases, 6 cases progressed to severe sepsis and 4 cases to septic shock. Two cases resulted in death.…”

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confidence: 94%