Affiliations: University of Tennessee College of Medicine,
University of Tennessee Health Science Center and Le Bonheur Children's
Hospital, Memphis, TN, USA | Department of Orthopedic Surgery – Campbell Clinic,
University of Tennessee Health Science Center and Le Bonheur Children's
Hospital, Memphis, TN, USA | Department of Pediatrics, University of Tennessee
Health Science Center and Le Bonheur Children's Hospital, Memphis, TN,
USA
Note: [] Correspondence: Derek M. Kelly, MD, Campbell Clinic, Department
of Orthopedic Surgery, University of Tennessee College of Medicine, 1458 W.
Poplar Ave., Suite 101, Collierville, TN 38071, USA. Tel.: +1 901 759 5552;
Fax: +1 901 759 5571; E-mail: dkelly@campbellclinic.com
Abstract: This report describes the clinical course and treatment of a C.
perfringens infection in a child following an injury to the knee that resulted
in sepsis and multi-organ system failure. Diagnosis of the causative agent and
systemic nature of the infection was delayed because of the non-traditional
presentation, in which the patient appeared to have a localized necrotizing
fasciitis and did not display symptoms consistent with severe systemic
involvement. He was treated with vancomycin, wound debridement and fasciotomy.
After identification of C. perfringens, vancomycin therapy was discontinued in
favor of penicillin and clindamycin. With intensive supportive care, the
patient recovered fully and resumed regular activities within two months. These
infections are rare in children, but they can be life threatening. It is
important to include systemic Clostridium infection in a differential so it can
be recognized early and appropriate treatment begun as soon as possible.
