• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Screening
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

A Rare Reversal of Clostridium perfringens Necrotizing Fasciitis

Article

While currently receiving chemotherapy with mitoxantrone for Gleason grade 7 prostate cancer, a 64-year-old man presented with rectal bleeding.

While currently receiving chemotherapy with mitoxantrone for Gleason grade 7 prostate cancer, a 64-year-old man presented with rectal bleeding. His medical history included non–small-cell lung cancer, for which he had undergone pneumonectomy; type 2 diabetes mellitus; and coronary artery disease. He had undergone coronary artery bypass grafting in the past.

The patient had a mild fever, tachycardia, and hypotension. Crepitus in his perineal area was found on palpation. Absolute neutrophil count was 650/µL. Despite appropriate initial resuscitation and prophylaxis with piperacillin/tazobactam and clindamycin, the patient decompensated, and he was intubated.

CT scans of the abdomen and pelvis showed a large prostatic mass without delineation between the prostate, rectum, and bladder. A fistula was noted between the rectum and bladder (A, B, and C). Copious subcutaneous gas was visible in the perineum and in all 3 corpora of the penis (D). Blood cultures were positive for Clostridium perfringens. Necrotizing fasciitis was diagnosed, and the patient underwent a loop colostomy.

The follow-up CT scans of the abdomen and pelvis depicted dramatic improvement (E). The extraluminal gas had nearly resolved. The patient’s clinical course was ultimately favorable, and he was discharged.

Recent Videos
"Vaccination is More of a Marathon than a Sprint"
Vaccines are for Kids, Booster Fatigue, and Other Obstacles to Adult Immunization
© 2024 MJH Life Sciences

All rights reserved.