Abstract

Background: Necrotizing soft-tissue infections, in particular clostridial myonecrosis (gas gangrene), represent acuteand potential life-threatening emergencies still associated with high mortality.

Objective: This report emphasizes that in case of gas gangrene very early identification followed by immediate aggressive interdisciplinary treatment are of utmost importance for survival.

Case presentation: A 70-year-old female was admitted with a giant umbilical hernia suffering from abdominal gas gangrene combined with severe septic shock. After emergency laparotomy, enhanced intravenous broad-spectrum-antibiotics and consistent hyperbaric oxygenation (HBO), the patient´s general condition improved considerably. During the further course she fully recovered and was discharged on the 14^th postoperative day.

Conclusion: This case is the first report of life-threatening abdominal gas gangrene induced by Clostridium paraputrificum treated successfully with emergency surgery, antibiotics and supportive HBO, respectively. By means of this promptly initiated multimodal emergency treatment the patient's life could be saved last-minute.

Keywords: Gas gangrene, necrotizing soft-tissue infection, emergency, mortality, septic shock, antibiotics, surgery, hyperbaric oxygenation