Clostridium septicum Necrotizing Fasciitis of the Forefoot Secondary to Adenocarcinoma of the Colon: Case Report and Review of the Literature

Abstract 

Clostridium septicum accounts for 1% of all reported clostridial infections. C septicum infections are most often nontraumatic in nature and associated with either an occult colonic or hematologic malignancy. The initial presentation of a C septicum infection can be relatively benign with rapid progression to fatality without emergent treatment. Presented is a case of necrotizing fasciitis of the forefoot caused by C septicum associated with an occult adenocarcinoma of the colon in a patient with uncontrolled diabetes. The process we used to achieve successful functional limb preservation based on rapid surgical intervention and use of a multidisciplinary approach to medical and surgical management of this patient is discussed in detail, as well as a through review of the literature regarding the association between malignancies and C septicum infections.

Level of Evidence: 4, Prognostic Study

Keywords: amputation, fillet flap, limb salvage, malignancy, skin graft