Postoperative Clostridial Myonecrosis of the Abdominal Wall

Clostridium sordellii, a Gram positive spore-forming anaerobe, is one of the lesser known members of the clostridia species. This microorganism is predominantly an animal pathogen, and it is rarely associated with disease in humans. Since its first report in 1922 only a few cases of abdominal infection have been reported and occasional cases of myonecrosis and gas gangrene have been published. We describe a case of postoperative clostridial myonecrosis after abdominal wall surgery. Despite presenting in critical condition, the patient improved after surgical debridement of the wound, aggressive hemodynamic resuscitation, source control and intravenous antibiotic therapy. The successful outcome in these cases might be related to early identification and institution of appropriate antibiotic treatment. The addition of prophylactic anti-anaerobe drugs should be strongly considered until an optimal prophylactic regimen judging from our experience and the reviewed literature.

Keywords: Clostridium sordellii; wound infections; necrotizing infection; rare clostridial infections.