Abstract
A case of non-clostridial gas gangrene (NCGG) developing in a plantar recalcitrant ulcer associated with diabetes mellitus (DM) is reported. A 63-year-old female was admitted to the hospital, because of a recalcitrant ulcer in the right first toe associated with DM. Following admission her right foot swelled, and plantar gangrene, excretion of pus with a foul smell, crepitation on pressing, and a gas picture on XP were noted. Therefore, a diagnosis of NCGG was made. Conservative treatment including administration of antibiotics and random skin cutting was carried out. However, her right leg was amputated after CT indicated expansion of the gas picture. NCGG often occurs in association with such underlying diseases as DM. Since this patient did not have her DM under adequate control, it is thought that the ulcer in the right first tow was the source of infection for the NCGG. The pathological progression of NCGG is relatively gradual, and the suitable period when it can be cured may be easily missed. Prognosis may become unfavorable. It is important to determine the causative bacteria in an early stage by gram-staining of the pus in order to make the differential diagnosis between NCGG and clostridial gas gangrene (CGG). If a curative tendency by conservative treatment is not observed, one should not hesitate to amputate the affected limb.
