A 76-year-old woman was admitted to our hospital because of a bleeding tendency. The complete blood cell count disclosed bicytopenia and the myelogram showed hyperplasticity. Abnormality in the cell morphology was noticed in both the peripheral blood and in the bone marrow. Ferrokinetic study revealed an increased plasma iron turnover rate and an ineffective iron turnover rate. Blast cell content in the bone marrow as less than 5%, and the content of ringed sideroblasts was less than 1%. Consequently, we diagnosed her disease as refractory anemia and began supplement therapy. However the patient died of septic shock due to gasproducing Escherichia coli, after five months of treatment.
This was a case of non-clostridial gas gangrene, but at the onset we could not detect crepitation and no gas image was seen on X-ray examination. Therefore diagnosis was difficult and the treatment was unsuccessful.
