Spontaneous, nontraumatic gangrene

Q: Which system amongst the following is more prone to origniate spontaneous (nontraumatic) gas gangrene? - Select one

A) Muscles

B) Genitourinary (GU) tract

C) Respiratory tract

D) Gastrointestinal (GI) tract

E) Hematologic source

Answer: D

Gastrointestinal lesions or undiagnosed adenocarcinoma of the colon should be suspected in patients who develop spontaneous gas gangrene.

The major predisposing factors:

• Colonic malignancy
• Inflammatory bowel disease (IBD)
• Diverticulitis
• GI surgery
• Leukemia
• Lymphoproliferative disorders
• Chemotherapy
• Neutropenia
• Radiation therapy
• Advanced AIDS
• Necrotizing enterocolitis, cecitis, or distal ileitis

#ID

#GI

#oncology

References:

1. Stevens DL, Musher DM, Watson DA, et al. Spontaneous, nontraumatic gangrene due to Clostridium septicum. Rev Infect Dis 1990; 12:286.

2. Johnson S, Driks MR, Tweten RK, et al. Clinical courses of seven survivors of Clostridium septicum infection and their immunologic responses to alpha toxin. Clin Infect Dis 1994; 19:761.

3. Alpern RJ, Dowell VR Jr. Clostridium septicum infections and malignancy. JAMA 1969; 209:385.

4. Srivastava I, Aldape MJ, Bryant AE, Stevens DL. Spontaneous C. septicum gas gangrene: A literature review. Anaerobe. 2017 Dec;48:165-171. doi: 10.1016/j.anaerobe.2017.07.008. Epub 2017 Aug 2. PMID: 28780428.