A case of gas gangrene with fatal outcome (gas gangrene: A case report)

Introduction: The clinical course of gas gangrene is often rapidly progressive, with a fatal outcome in up to 80% of treated cases. The disease is most commonly a consequence of trauma or surgical interventions. The causative agents are bacteria of the genus Clostridium. Tissue changes are induced by bacterial toxins. Case presentation: We analyzed the case of an 84-year-old, obese, female patient admitted for treatment due to weakness and dysuric symptoms. She fell at home the day before and sustained superficial skin changes. Previous medical documentation indicated poorly managed arterial hypertension. A few days after admission, the patient experienced worsening symptoms with the onset of edema and crepitus of the soft tissues, dyspnea, and renal insufficiency. Ultrasound examination revealed gas inclusions in muscular tissue, while radiography showed bilateral basal pulmonary changes. Laboratory findings initially showed lymphocytosis and elevated C-reactive protein. Anemia, increased muscle enzymes, and elevated nitrogenous compounds followed the progression of the disease. Urine culture isolated Escherichia coli. Clostridium spp. was identified in the soft tissue aspirate. Ceftriaxone and metronidazole were administered initially, followed by penicillin G. The disease progressed and resulted in a fatal outcome. Conclusion: The nature of gas gangrene is extremely severe due to the potential for multisystemic damage. It is necessary to suspect this condition more frequently, regardless of the circumstances of the injury. Clinical symptoms should be closely monitored, and antibiotic therapy should be initiated as early as possible to improve the chances of a favorable outcome.