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
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The Journal of Foot and Ankle Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Atraumatic clostridial myonecrosis: case report and literature review.J Emerg Med. 2003; 24: 401-405
- Spontaneous fulminant gas gangrene.Emerg Med J. 2005; 22: 520-521
- Phenotyping Clostridium septicum infection: a surgeon's infectious disease.J Surg Res. 2008; 148: 67-76
- Clostridium septicum infection and associated malignancy. Report of 2 cases and review of the literature.Medicine (Baltimore). 1989; 68: 30-37
- A Case of Clostridium septicum spontaneous gas gangrene.Can J Emerg Med. 2007; 9: 133-135
- Occult clostridial myonecrosis.Ann Emerg Med. 1981; 10: 307-311
- Clostridial septicemia.Cancer. 1972; 29: 215-221
- Nontraumatic gas gangrene: case report and review of emergency therapeutics.J Emerg Med. 1991; 9: 431-436
- Malignancy, mortality, and medicosurgical management of Clostridium septicum infection.Surgery. 1995; 118: 592-598
- Nontraumatic clostridial myonecrosis: an infectious disease emergency.Ann Emerg Med. 1981; 10: 312-314
- Clostridium septicum and malignancy.ANZ J Surg. 2001; 71: 647-649
- C septicum infections and malignancy.J Amer Med Assoc. 1969; 209: 385-388
- Recognition, management, and prevention of Clostridium septicum abscess in immunosuppressed patients.Arch Surg. 1991; 126: 642-645
- Clostridium septicum myonecrosis in association with colonic malignancy.Conn Med. 1988; 52: 709-710
- Clostridium septicum gas gangrene of the gluteus maximus and an ascending colon malignant tumor: a case report.Clin Orthop Rel Res. 1994; 308: 178-182
- A reminder of the association between Clostridium septicum and colonic adenocarcinoma.Int Sem Surg Onc. 2006; 28: 12
- Clostridium septicum bacteremia: its clinical significance.Am J Med. 1979; 66: 63-66
- Unusual bacterial infections and colorectal carcinoma—Streptococcus bovis and Clostridium septicum: report of three cases.Dis Col Rec. 2006; 49: 1223-1227
- Spontaneous bifocal Clostridium septicum gas gangrene.J Bone Joint Surg Br. 2001; 83: 115-116
- Non-traumatic Clostridium septicum arthritis in a patient with caecal carcinoma.Br J Rheumatol. 1992; 31: 571-572
- Panophthalmitis due to Clostridium septicum.Am J Opth. 2004; 137: 942-944
- Spontaneous clostridial myonecrosis: a collective review and report of a case.Annal Chirug Gyn. 1986; 75: 274-279
- Effect of diet on human fecal flora: comparison of Japanese and American diets.Am J Clin Nutr. 1974; 27: 1456-1469
- Metastatic gas gangrene and colonic perforation: a case report.World J Emerg Surg. 2008; 28: 15
- Invasive Clostridium septicum infection in association with colorectal carcinoma.Can J Surg. 1994; 37: 371-372
- Extra-articular ankle immobilization for protection of percutaneous tendo-Achilles lengthening after transmetatarsal amputation and peripheral arterial bypass surgery.J Foot Ankle Surg. 2008; 47: 169-171
- Fatal multifocal metastasis of Clostridium septicum: a case report.Brit Assoc Plast Surg. 2004; 57: 673-675
- The filleted toe flap.Br J Plast Surg. 1976; 29: 19-21
- Filleted toe flap for chronic forefoot ulcer reconstruction.Ann Plast Surg. 2000; 44: 412-416
Published online: November 30, 2009
Disclaimer: The opinions or assertions contained herein are the private view of the author and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.