Extensive clostridial myonecrosis after gluteal intramuscular injection in immunocompromised patient treated with surgical debridement and negative-pressure wound therapy

• DOI: 10.1016/j.tcr.2021.100469
• Publication Date: 2021-03-19T16:26:43Z
• Authors: Laurine Paquier; Jakov Mihanović; Antoine Counil; Robert Karlo; Ivan Bačić; Boris Dželalija
• Keywords: Gas gangrene; Clostridium perfringens; Anaerobic infection; Debridement (dental); Negative-pressure wound therapy; Antibiotic Therapy; Intramuscular injection; Buttocks; Gluteal muscles

Gas gangrene is infectious disease caused by Clostridium perfringens infection. We are presenting extremely rare case of gluteal clostridial myonecrosis after intramuscular injection diclofenac in immunocompromised young patient on a long-standing corticosteroid therapy presented with sepsis and initially absent clinical signs severe anaerobic After delayed diagnosis, she was treated aggressive surgical removal necrosed tissue targeted antibiotic which led to rapid improvement allowing application negative-pressure wound device favorable outcome. This report shows the importance timely diagnosis pitfalls imaging. It confirms that debridement along specific mainstay treatment, but also promotes has proved convenient for accelerated closure large incisions loss without any adverse effects or need complex reconstructive procedures.