Atraumatic Clostridium septicum myonecrosis presenting as upper limb ischaemia in a patient with undiagnosed bowel cancer

Ann R Coll Surg Engl. 2022 Apr;104(4):e95-e97. doi: 10.1308/rcsann.2021.0153. Epub 2021 Nov 26.

Abstract

Necrotising infections remain challenging to surgeons, both in diagnosis and management. Timely recognition and treatment remain vital. We report a presentation of limb ischaemia with no apparent precipitating factors, in a systemically stable patient, due to atraumatic Clostridium septicum myonecrosis. This article demonstrates the use of rapid cross-sectional imaging in finding an undiagnosed bowel cancer as a basis for this type of infection. Rapid cross-sectional imaging may be utilised where there is doubt about the underlying pathology of upper limb ischaemia. Patients whose cultures grow Clostridium septicum must be investigated for malignancy.

Keywords: Cancer; Clostridial; Limb ischaemia; Myonecrosis; Necrotising.

MeSH terms

  • Clostridium Infections* / complications
  • Clostridium Infections* / diagnosis
  • Clostridium septicum*
  • Colorectal Neoplasms*
  • Gas Gangrene* / diagnosis
  • Gas Gangrene* / etiology
  • Gas Gangrene* / therapy
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology