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Plast Reconstr Surg Glob Open 2021 Jun 15;9(6):e3625. Epub 2021 Jun 15.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

is an anaerobe associated with freshwater and marine life. Necrotizing soft tissue infection caused by is rare, but its mortality rate is extremely high (61.1%). Read More

Int J Surg Case Rep 2021 Jun 11;84:106061. Epub 2021 Jun 11.

Department of Orthopaedic and Traumatology, Sanglah General Hospital, Medical Faculty of Udayana University, Bali, Indonesia.

Introduction: Traditional bone setter's gangrene is a devastating complication arising from the practice of TBS with a prevalence of 4.29%, and most cases require amputation, which led to permanent disability. This case demonstrates a catastrophic presentation of the lower limb gangrene secondary to traditional bone setter's treatment. Read More

JBJS Essent Surg Tech 2021 Jan-Mar;11(1). Epub 2021 Mar 2.

Université Nazi Boni, Bobo-Dioulasso, Burkina Faso.

Background: We performed open osteoclasis, soft-tissue release, and fracture fragment reduction and fixation to treat 10 cases of neglected physeal fractures of the distal aspect of the femur with severe deformity. To our knowledge, no specific surgical procedure for this problem has been reported in the literature.

Description: The procedure is typically performed through an extensile anterolateral approach. Read More

Vet Rec 2021 Jun 9:e558. Epub 2021 Jun 9.

Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria.

Background: Blackleg and gas gangrene are acute clostridial infections primarily affecting cattle. The objectives of this study were to identify (i) animal-related factors influencing the occurrence and (ii) prognostic pathological findings supporting the differentiation of fatal blackleg and gas gangrene cases in the cattle population from 1998 to 2018 in Styria, Austria.

Methods: Two binomial logistic models were applied to analyse the research questions. Read More

Microbiol Mol Biol Rev 2021 Jun 2:e0006421. Epub 2021 Jun 2.

Molecular Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.

Large clostridial toxins (LCTs) are a family of bacterial exotoxins that infiltrate and destroy target cells. Members of the LCT family include Clostridioides difficile toxins TcdA and TcdB, Paeniclostridium sordellii toxins TcsL and TcsH, Clostridium novyi toxin TcnA, and Clostridium perfringens toxin TpeL. Since the 19th century, LCT-secreting bacteria have been isolated from the blood, organs, and wounds of diseased individuals, and LCTs have been implicated as the primary virulence factors in a variety of infections, including C. Read More

Acta Chir Plast 2021 ;63(1):18-22

Gas gangrene is a rare and potentially fatal surgical complication, most often associated with contaminated traumatic wounds or more rarely following cases of abdominal surgery. The following article describes a case of gas gangrene in the right lower limb of a 34-year-old patient following an elective posterior tibial tendon transfer. The surgery was performed in bloodless fashion, utilizing a surgical tourniquet. Read More

IDCases 2021 22;24:e01129. Epub 2021 Apr 22.

University of California, San Francisco, 155 N Fresno St, Suite 307, Fresno, CA, 93701, United States.

species are known to cause myonecrosis and gas gangrene which are often fatal infections in the setting of trauma but also spontaneously in certain populations such as colorectal malignancy, immunosuppression, and neutropenia. We report a case of an 83-year-old male who developed fatal and rapidly progressive gas gangrene due to within 48 h after biopsy of suspected malignant cecal mass. To our knowledge, such a drastic, rapid and fatal presentation after a diagnostic biopsy of malignant mass has not been previously reported and is something to be watchful for in suspected colon cancer cases. Read More

J Surg Case Rep 2021 May 5;2021(5):rjab172. Epub 2021 May 5.

Department of General Surgery, Nizwa Hospital, Nizwa, Al Dakhiliya, Oman.

We reported a rare complication of laparoscopic appendectomy in a 19-year-old patient, who was admitted with acute appendicitis and had no history of inguinal hernia. He underwent laparoscopic appendectomy for suppurative appendicitis. Eight days later, he presented with irreducible incarcerated right inguinal hernia. Read More

J Int Med Res 2021 May;49(5):3000605211012201

Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510610, China.

We herein review and analyze the diagnosis, treatment, and outcome of a severe infection caused by a human bite. A 68-year-old man was bitten on the forearm by a 3-year-old child. Rapid progression of infection, severe local and systemic poisoning, and diverse clinical manifestations were observed at presentation. Read More

Wounds 2021 Jan;33(1):E10-E13

Shimane University, Shimane, Japan.

Introduction: Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina.

Case Report: A 61-year-old female patient was admitted to the authors' hospital with swelling, extending from the left thigh to the left lower abdomen and crepitus. An axial computed tomography scan showed air in the soft tissue of the left thigh, left buttock, perineal region, and left lower abdomen. Read More

Trop Anim Health Prod 2021 Apr 23;53(2):284. Epub 2021 Apr 23.

Department of Anaerobic Vaccine Research and Production, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Shahid Beheshti Blvd., P.O. Box: 31975/148, Hesarak, Karaj, Alborz Province, Iran.

Clostridium is a Gram-positive, rod-shaped, anaerobic, and spore-forming bacterium, which is found in the surrounding environments throughout the world. Clostridium species cause botulism, tetanus, enterotoxaemia, gas gangrene, necrotic enteritis, pseudomembranous colitis, blackleg, and black disease. Clostridium infection causes severe economic losses in livestock and poultry industries. Read More

Am J Case Rep 2021 Apr 21;22:e930889. Epub 2021 Apr 21.

Department of Pharmacy, Mercy Health - St. Elizabeth Youngstown Hospital, Youngstown, OH, USA.

BACKGROUND Clostridial myonecrosis, also known as gas gangrene, is a highly lethal necrotizing soft tissue infection. While commonly associated with trauma, clostridial myonecrosis may be the result of parenteral injection of medications. Epinephrine is the most commonly reported medication leading to gas gangrene. Read More

Virulence 2021 Dec;12(1):723-753

Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

is an extremely versatile pathogen of humans and livestock, causing wound infections like gas gangrene (clostridial myonecrosis), enteritis/enterocolitis (including one of the most common human food-borne illnesses), and enterotoxemia (where toxins produced in the intestine are absorbed and damage distant organs such as the brain). The virulence of this Gram-positive, spore-forming, anaerobe is largely attributable to its copious toxin production; the diverse actions and roles in infection of these toxins are now becoming established. Most toxin genes are encoded on conjugative plasmids, including the pCW3-like and the recently discovered pCP13-like plasmid families. Read More

Trauma Case Rep 2021 Apr 18;32:100469. Epub 2021 Mar 18.

Department of Health Studies, University of Zadar, Croatia.

Gas gangrene is infectious disease caused by 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. Read More

ANZ J Surg 2021 Apr 8. Epub 2021 Apr 8.

Department of General Surgery, The University of Tunis El Manar, Ben Arous, Tunisia.

Med Clin (Barc) 2021 Mar 22. Epub 2021 Mar 22.

Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.

Front Cell Infect Microbiol 2021 8;11:633440. Epub 2021 Mar 8.

Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Japan.

Toll-like receptor 4 (TLR4) has been reported to protect against Gram-negative bacteria by acting as a pathogen recognition receptor that senses mainly lipopolysaccharide (LPS) from Gram-negative bacteria. However, the role of TLR4 in Gram-positive bacterial infection is less well understood. type A is a Gram-positive bacterium that causes gas gangrene characterized by severe myonecrosis. Read More

J Obstet Gynaecol Res 2021 Jun 21;47(6):2230-2233. Epub 2021 Mar 21.

Department of Obstetrics and Gynecology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.

Sigmoid volvulus is one of the most common reasons for intestinal obstruction. Recurrent sigmoid volvulus occurred in only a few cases. Torsion of the sigmoid colon around the mesenteric portion initiates ischemia, gangrene, and perforation. Read More

World J Clin Cases 2021 Feb;9(5):1215-1220

Department of Urology, Military Institute of Medicine, Warsaw 04-141, Poland.

Background: Fournier's gangrene (FG) is a serious, aggressive and often deadly polymicrobial infection of the soft tissues of the perineum, the rectum and the external genital organs. It is an anatomical subcategory of necrotizing fasciitis, which has a similar etiology and treatment strategy.

Case Summary: A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38. Read More

Med Gas Res 2021 Jan-Mar;11(1):18-23

Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

There is no consensus about the role of adjunctive hyperbaric oxygen therapy (HBOT) in the management of Fournier's gangrene. The aim of this study was to compare the evolution of patients with Fournier's gangrene treated with all classical measures with and without adjuvant HBOT. A retrospective comparative study regarding the evolution of patients treated for Fournier's gangrene was conducted in two periods. Read More

J Appl Microbiol 2021 Feb 8. Epub 2021 Feb 8.

Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Aims: The inhibitory and bactericidal effect of a wide range of essential oils, and their selected combinations against two pathogens (Clostridium perfringens and Clostridium septicum), the causative pathogens of gas gangrenous infections were investigated. Fractional inhibitory indices were also calculated to determine the interactions.

Methods And Results: The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) assays were used to determine the efficacy of the essential oils. Read More

AJR Am J Roentgenol 2021 03 13;216(3):812-823. Epub 2021 Jan 13.

Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH.

The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement. Read More

Vet Radiol Ultrasound 2021 May 16;62(3):309-315. Epub 2020 Dec 16.

Diagnostic Imaging Department, Pride Veterinary Centre, Derby, UK.

Spontaneous emphysematous splenitis is a life-threatening condition reported rarely in humans; however, published reports in dogs are currently lacking. The aim of this multicentric, retrospective, case series design study was to describe radiographic and ultrasonographic imaging findings in Golden Retriever dogs diagnosed with spontaneous emphysematous splenitis. A total of three dogs were sampled. Read More

Infect Dis Clin North Am 2021 Mar 7;35(1):135-155. Epub 2020 Dec 7.

David Geffen School of Medicine at UCLA, Los Angeles, CA 90074, USA; R M Alden Research Laboratory, 2021 Santa Monica Boulevard, Suite #740 East, Santa Monica, CA 90404, USA.

Necrotizing soft tissue infections occur after traumatic injuries, minor skin lesions, nonpenetrating injuries, natural childbirth, and in postsurgical and immunocompromised patients. Infections can be severe, rapidly progressive, and life threatening. Survivors often endure multiple surgeries and prolonged hospitalization and rehabilitation. Read More

Australas J Dermatol 2020 Dec 5. Epub 2020 Dec 5.

Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Anaerobe 2020 Dec 29;66:102287. Epub 2020 Oct 29.

Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, USA. Electronic address:

Clostridium perfringens strains cause a wide variety of human and animal disease, including gas gangrene or myonecrosis. Production of toxins required for myonecrosis, PFO and CPA, is regulated by the C. perfringens Agr-like (CpAL) system via the VirSR two-component system. Read More

Clin Cancer Res 2021 Jan 12;27(1):96-106. Epub 2020 Oct 12.

BioMed Valley Discoveries Inc., Kansas City, Missouri.

Purpose: Intratumorally injected -NT (nontoxic; lacking the alpha toxin), an attenuated strain of , replicates within hypoxic tumor regions resulting in tumor-confined cell lysis and inflammatory response in animals, which warrants clinical investigation.

Patients And Methods: This first-in-human study (NCT01924689) enrolled patients with injectable, treatment-refractory solid tumors to receive a single intratumoral injection of -NT across 6 dose cohorts (1 × 10 to 3 × 10 spores, 3+3 dose-escalation design) to determine dose-limiting toxicities (DLT), and the maximum tolerated dose.

Results: Among 24 patients, a single intratumoral injection of -NT led to bacterial spores germination and the resultant lysis of injected tumor masses in 10 patients (42%) across all doses. Read More

Orthop Surg 2020 Dec 4;12(6):1733-1747. Epub 2020 Oct 4.

Department of Trauma, Hand, and Reconstructive Surgery, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.

Objective: Clostridial gas gangrene (GG) or clostridial myonecrosis is a very rare but life-threatening necrotizing soft tissue infection (NSTI) caused by anaerobic, spore-forming, and gas-producing clostridium subspecies. It is the most rapidly spreading and lethal infection in humans, also affecting muscle tissue. The high mortality, of up to 100%, in clostridial GG is mediated by potent bacterial exotoxins. Read More

Int J Surg Case Rep 2020 10;75:297-301. Epub 2020 Sep 10.

Department of Surgery, Gaston Berger University, Saint-Louis, Senegal.

Introduction: Colonic volvulus is defined as a torsion of a part of the colon causing large bowel obstruction by strangulation which may lead to ischemia and then necrosis. The synchronous occurrence of a sigmoid colon and transverse colon volvulus is exceptional. We describe a case of synchronous sigmoid and transverse volvulus in a patient with a qualitative systematic review of this condition. Read More

Updates Surg 2020 Sep 2;72(3):565-572. Epub 2020 Sep 2.

Day Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Pad. Zonda, 20122, Milan, Italy.

Medical services in WWI had to face enormous new problems: masses of wounded, most with devastating wounds from artillery splinters, often involving body cavities, and always contaminated. Tetanus, gas gangrene, wound infections were common and often fatal. Abdominal wounds were especially a problem: upon entering the war the commanders of all medical services ordered to avoid surgery, based on dismal experiences of previous wars. Read More