PT  - JOURNAL ARTICLE
AU  - Carolyn Cullinane
AU  - Helen Earley
AU  - Shona Tormey
TI  - Deadly combination: <em>Clostridium septicum</em> and colorectal malignancy
AID  - 10.1136/bcr-2017-222759
DP  - 2017 Dec 02
TA  - BMJ Case Reports
PG  - bcr-2017-222759
VI  - 2017
4099  - http://casereports.bmj.com/content/2017/bcr-2017-222759.short
4100  - http://casereports.bmj.com/content/2017/bcr-2017-222759.full
AB  - Gas gangrene is a life-threatening, necrotising soft tissue infection. Colorectal malignancy-associated Clostridiumsepticum is a rare cause of gas gangrene. This case outlines an initial presentation of colonic malignancy as gas gangrene from C.septicum infection.A 69-year-old man presented with abdominal pain, vomiting and constipation. Abdominal X-ray revealed dilated small bowel loops. Lactate was elevated. A diagnosis of small bowel obstruction was made. Subsequent CT revealed caecal thickening and subcutaneous emphysema overlying the left flank. Clinically, he became haemodynamically unstable. Examination revealed crepitus overlying the left flank in keeping with gas gangrene. The patient required immediate surgical debridement. Tissue specimens cultured C.septicum. Following a complicated postoperative period, he was transferred to the plastic surgery team for further tissue debridement and reconstruction. A colonoscopy was later performed which was suspicious for malignancy. Colorectal multidisciplinary team discussion is awaited.