Abstract
A case of anaerobic cellulitis accompanied by gas-containing abscess and complicated by rhabdomyolysis is reported. A 60-year old woman came to our hospital because of fever and pain and swelling of her right great toe of 3 days duration and was admitted for evaluation and treatment. A diagnosis of diabetes mellitus had been made 6 years be-fore, and the patient had been treated with insulin at a general practitioner's clinic. She had removed a corn from her right great toe 5 days before. On admission, she had a fever of 39C and her great toe was red and swollen. Leukocytosis and an elevated serum CRP level were noted. Intravenous antibiotics were started, however, her fever persisted, and the redness spread to her foot, and the swelling extended to her leg. An ulcer developed at the site of the corn, and purulent discharge was noted. On the 7th hospital day, increased serum levels of CPK and myoglobin were found. On the 10th hospital day, gas was observed on the X-ray films of her leg, and emergency surgery was performed. A large amount of gas-containing pus was drained from her leg. There was extensive necrosis of the subcutaneous tissue, but the muscle fascia seemed to be intact. Peptostreptococcus was cultured from the pus. Postoperatively the patient's fever resolved, and her elevated CPK and myoglobin levels became normal.
