Case Report
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 7, 2011; 17(33): 3856-3858
Published online Sep 7, 2011. doi: 10.3748/wjg.v17.i33.3856
A case of gas gangrene in an immunosuppressed Crohn’s patient
Natalie Kiel, Vincent Ho, Andrew Pascoe
Natalie Kiel, Vincent Ho, Andrew Pascoe, Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, 4102 Queensland, Australia
Author contributions: Kiel N, Ho V and Pascoe A wrote the case report.
Correspondence to: Dr. Natalie Kiel, MBBS, BSc, Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, 4102 Queensland, Australia.
Telephone: +61-73176-2111 Fax: +61-73176-7366
Received: February 19, 2011
Revised: March 26, 2011
Accepted: April 2, 2011
Published online: September 7, 2011

Clostridium septicum (C. septicum) gas gangrene is well documented in the literature, typically in the setting of trauma or immunosuppression. In this paper, we report a unique case of spontaneous clostridial myonecrosis in a patient with Crohn’s disease and sulfasalazine-induced neutropenia. The patient presented with left thigh pain, vomiting and diarrhea. Blood tests demonstrated a profound neutropenia, and magnetic resonance imaging of the thigh confirmed extensive myonecrosis. The patient underwent emergency hip disarticulation, followed by hemicolectomy. C. septicum was cultured from the blood. Following completion of antibiotic therapy, the patient developed myonecrosis of the right pectoral muscle necessitating further debridement, and remains on lifelong prophylactic antibiotic therapy.

Keywords: Crohn’s disease, Inflammatory bowel disease, Sulfasalazine, Neutropenia, Clostridium septicum