A 50-year-old male patient presented with severe excruciating pain in the shoulder region along with swelling and fever. There was no history of any kind of trauma. Bullae filled with clear, cloudy, haemorrhagic, or purplish fluid were observed at the site of pain and the surrounding skin had a purple hue. A pleomorphic bacillus forming oval subterminal spores was observed on gram staining. It grew in anaerobic conditions on culture. The colonies were initially irregular and transparent which turned opaque on repeated incubations. The organism was saccharolytic and produced abundant gas on fuher studies. Which investigation should be carried out next to rule out the root cause of above condition: –
Correct Answer: GI Endoscopy
Description: This is a case of spontaneous gas gangrene which occurs in the setting of a GI pathology and is caused most commonly by clostridium septicum. The microbiological features described in the question point towards clostridium septicum infection. Occurs hematogenous seeding of normal muscle with histotoxic clostridia This is seen principally with C. perfringens, C. septicum, and C. novyi and occasionally C. teium. Come from GI tract poal entry Presents with excruciating pain in absence of trauma.
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