Clostridium septicum myonecrosis in a child with aplastic anemia treated successfully with conventional therapy and bone marrow transplantation

Myonecrosis due to Clostridium septicum in patients with neutropenia is associated with an extremely high mortality rate [Jendrzejewski, J.W., Jones, S.R., Newcombe, R.L. et al. (1978). Non-traumatic clostridial myonecrosis. Am I Med, 65, 542-546]. We describe a 12-year-old boy with idiopathic aplastic anemia who developed gas gangrene of his right leg due to Clostridium septicum. His infection was treated aggressively with conventional therapy, which included amputation, debridement and hyperbaric oxygen. He continued to have intermittent fevers and extension of cellulitis. Because of his refractory neutropenia, open wound, and high likelihood of dying from his infection, we proceeded with an HLA-matched sibling bone marrow transplantation (BMT) three weeks following his amputation. The transplanted marrow successfully engrafted, the patient fully recovered and was discharged 90 days after the onset of illness.