Clostridial gas gangrene involving the brain, gallbladder, heart, and soft tissue: A case report and literature review

Clostridial gas gangrene (CGG) is among the most rapidly spreading infections in humans, with mortality rates approaching 100 % if not treated promptly. Most cases follow traumatic inoculation, although spontaneous infections occur in a minority of patients with immunodeficiency. Spontaneous CGG is primarily caused by Clostridium septicum , whereas traumatic infection is associated with Clostridium perfringens . Patients with CGG present abruptly with rapidly progressive symptoms, underscoring the importance of early recognition, prompt surgical intervention, and appropriate antimicrobial therapy. We describe an illustrative case of spontaneous CGG caused by C. perfringens in a polymorbid 73-year-old female patient. Despite aggressive medical and surgical management, she succumbed to metastatic infection within 48 h of presentation. • Rare case of clostridial gas gangrene involving at least four organs. • Clostridium perfringens can cause gas gangrene in the absence of traumatic injury. • NSTIs may present atypically at unsuspecting sites of infection in polymorbid patients. • Surrogate markers may alert clinicians to NSTI diagnosis before surgical exploration. • Delayed surgical intervention increases patient morbidity and mortality.