Clostridial myonecrosis following intra-articular steroid injection

Fatal clostridial myonecrosis occurred in a 65-year-old man after intra-articular injection of steroids to the shoulder joint. Clinical evidence of the possibility of clostridial infection is sufficient reason to initiate treatment. The opportunity to save a life may be lost by waiting for paraclinical data for definitive diagnosis to initiate treatment. "Surgical skin prep" for every intra-articular injection is a preventive measure. Increasing joint pain after intraarticular injection should be considered a serious complaint and requires careful clinical follow-up observations.