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Gas gangrene secondary to Clostridium perfringens in pediatric oncology patients
Ana-Maria M Temple1, Neal J Thomas
1Department of Pediatrics, Penn State Children's Hospital, Hershey, PA 17033, USA.
Insights
Severe gas gangrene caused by Clostridium perfringens is a rare but dangerous infection in pediatric cancer patients. Early diagnosis and aggressive treatment, including surgery, are crucial for survival.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Critical Care Medicine
Background:
- Clostridium perfringens can cause severe gas gangrene.
- This condition is rare in pediatric oncology patients.
Observation:
- Two pediatric oncology patients presented with acute gas gangrene.
- Both patients experienced rapid decompensation and required limb amputation.
Findings:
- One patient survived, while the other expired despite aggressive treatment.
- Gas gangrene is a life- and limb-threatening condition in this population.
Implications:
- Prompt recognition and aggressive treatment, including surgical intervention, are critical.
- A high index of suspicion in immunocompromised children with neutropenia and extremity pain is essential for early diagnosis and improved survival.
- Emergency medicine physicians must be aware of this severe infectious process and consult orthopedic surgery promptly.
Objective:
To report 2 cases of severe gas gangrene secondary to Clostridium perfringens in pediatric oncology patients.
Methods:
We describe 2 children with acute presentations of gas gangrene secondary to C. perfringens. Both children were initially seen and treated in a community hospital emergency department and subsequently were cared for in a pediatric intensive care unit in a tertiary care, university-based children's hospital.
Results:
Both children demonstrated severe and unrelenting decompensation and required operative intervention within the first hospital day, which included amputation of the infected limb. One child survived and one child expired despite heroic measures.
Conclusions:
Gas gangrene secondary to C. perfringens is an uncommon but life-threatening and limb-threatening condition in pediatric cancer patients. A high index of suspicion in a immunocompromised child with cancer who presents with extremity pain in combination with neutropenia is the key to early diagnosis and may lead to improved survival. This disease requires prompt recognition and aggressive treatment to allow any hope of recovery. Emergency medicine physicians who treat these children should be aware of this severe and potentially fatal infectious process and should not delay treatment or prompt orthopedic surgery consultation.
