Abstract

Gas gangrene is a very rare infection nowadays because of perfection of aseptic surgery, use of varieties of antibiotics and absence of war casualties. Recently we had a
case
of gas gangrene developed following an open fracture, on a 44-year-old male. The authors made bacteriological studies of the case and the result is presented together with the clinical pictures. 1. Inspite of adequate treatment of the open fracture of his right femur and tibia, he developed gas gangrene with typical signs such as severe myonecrosis, subcutaneous vesicles and crepitus, erythematous changes of the skin and with symptoms of toxemia. 2. Gram stained smears of the exudate and tissue fragments from the lesion revealed a large number of gram-positive bacilli. Culture of the specimens yielded Clostridium perfringens which were with typical cultural and biochemical characteristics of the species. Enterobacter and Klebsiella pneumoniae were concomitantly isolated from the specimens. 3. Disk diffusion susceptibility test showed the Clostridium was susceptible to penicillin, chloramphenicol, clindamycin, cephalothin, and tetracycline and resistant to erythromycin. The above-knee amputation and then the hip disarticulation with the massive penicillin and other antibiotics treatment were without effect and the patient expired on the 23rd post operative day. This case demonstrated the severe nature of gas gangrene even in the era of modern medicine.