PDF(Pubmed)
Abstract：
UNASSIGNED: Clostridium perfringens is a well-known cause of gas gangrene with a very high mortality rate. Multiple cases of internal organs have been reported in the literature; however, non-traumatic spontaneous gas gangrene due to C. perfringens with solely cardiac involvement in a patient without any risk factors has not been reported before.
UNASSIGNED: A 52-year-old male presented to the emergency department with chest pain and exertional dyspnoea for three days. The patient was haemodynamically stable initially, and the physical examination was unremarkable. Initial laboratory workup revealed elevated D-dimer and troponin levels. Computerized tomography (CT) of the chest was negative for pulmonary embolism but showed a hypodense focus in the cardiac silhouette. Acute coronary syndrome protocol was initiated; however, invasive cardiac workup was negative. The patient had rapid clinical deterioration with development of respiratory failure, shock, and multiorgan failure within 24 h. A transesophageal echocardiogram demonstrated an abnormal echogenic focus, corresponding to CT chest area. Despite aggressive treatment, the patient passed away within 36 h. Later, the patient\'s blood culture grew C. perfringens. A limited autopsy showed an abscess cavity in the interventricular septum, pathology of which revealed acute myocarditis and fibrinous pericarditis.
UNASSIGNED: Unlike other reported cases of C. perfringens with cardiac abscess, our patient had no known risk factors, and no other organs were involved. We conclude from this case that an air focus on the CT scan in the myocardium can be suggestive of a spontaneous gas gangrene of the myocardium, and the patients should be treated accordingly.
UNASSIGNED: A 52-year-old male presented to the emergency department with chest pain and exertional dyspnoea for three days. The patient was haemodynamically stable initially, and the physical examination was unremarkable. Initial laboratory workup revealed elevated D-dimer and troponin levels. Computerized tomography (CT) of the chest was negative for pulmonary embolism but showed a hypodense focus in the cardiac silhouette. Acute coronary syndrome protocol was initiated; however, invasive cardiac workup was negative. The patient had rapid clinical deterioration with development of respiratory failure, shock, and multiorgan failure within 24 h. A transesophageal echocardiogram demonstrated an abnormal echogenic focus, corresponding to CT chest area. Despite aggressive treatment, the patient passed away within 36 h. Later, the patient\'s blood culture grew C. perfringens. A limited autopsy showed an abscess cavity in the interventricular septum, pathology of which revealed acute myocarditis and fibrinous pericarditis.
UNASSIGNED: Unlike other reported cases of C. perfringens with cardiac abscess, our patient had no known risk factors, and no other organs were involved. We conclude from this case that an air focus on the CT scan in the myocardium can be suggestive of a spontaneous gas gangrene of the myocardium, and the patients should be treated accordingly.
摘要：
UNASSIGNED：产气荚膜梭状芽胞杆菌是众所周知的气体坏疽的原因，死亡率非常高。文献中报道了多例内脏器官的病例；然而，在没有任何危险因素的患者中，由产气荚膜梭菌引起的非创伤性自发性气体坏疽没有报道。
未经证实：一名52岁男性因胸痛和劳力性呼吸困难3天到急诊科就诊。患者最初血流动力学稳定，体检并不明显。最初的实验室检查显示D-二聚体和肌钙蛋白水平升高。胸部计算机断层扫描（CT）对肺栓塞阴性，但在心脏轮廓中显示出低密度病灶。启动了急性冠状动脉综合征方案；然而，有创心脏检查结果为阴性.随着呼吸衰竭的发展，患者的临床症状迅速恶化，震惊,24小时内多器官衰竭。经食管超声心动图显示异常回声灶，对应于CT胸部区域。尽管积极治疗，病人在36小时内去世。后来，病人的血培养培养出产气荚膜梭菌。有限的尸检显示室间隔有脓肿腔，病理提示急性心肌炎和纤维性心包炎。
未经证实：与其他报道的产气荚膜梭菌伴心脏脓肿病例不同，我们的病人没有已知的危险因素，没有其他器官参与其中。我们从这种情况下得出的结论是，心肌CT扫描的空气焦点可以暗示心肌的自发性气体坏疽，患者应该得到相应的治疗。
未经证实：一名52岁男性因胸痛和劳力性呼吸困难3天到急诊科就诊。患者最初血流动力学稳定，体检并不明显。最初的实验室检查显示D-二聚体和肌钙蛋白水平升高。胸部计算机断层扫描（CT）对肺栓塞阴性，但在心脏轮廓中显示出低密度病灶。启动了急性冠状动脉综合征方案；然而，有创心脏检查结果为阴性.随着呼吸衰竭的发展，患者的临床症状迅速恶化，震惊,24小时内多器官衰竭。经食管超声心动图显示异常回声灶，对应于CT胸部区域。尽管积极治疗，病人在36小时内去世。后来，病人的血培养培养出产气荚膜梭菌。有限的尸检显示室间隔有脓肿腔，病理提示急性心肌炎和纤维性心包炎。
未经证实：与其他报道的产气荚膜梭菌伴心脏脓肿病例不同，我们的病人没有已知的危险因素，没有其他器官参与其中。我们从这种情况下得出的结论是，心肌CT扫描的空气焦点可以暗示心肌的自发性气体坏疽，患者应该得到相应的治疗。
