Epinephrine Auto-Injection After Allergic Reaction Leading to Gas Gangrene of the Leg
| Autor: | Darius Shams, Vincent Peyko, Allison R Lauver |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Epinephrine Clostridium perfringens Injections Subcutaneous medicine.medical_treatment medicine.disease_cause Hypersensitivity medicine Animals Humans Fasciitis Right Thigh Leg Debridement business.industry Insect Bites and Stings Articles General Medicine Emergency department Bees medicine.disease Bee stings Anti-Bacterial Agents Anesthesia Tomography X-Ray Computed business Gas Gangrene Gas gangrene medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| DOI: | 10.12659/ajcr.930889 |
| Popis: | Patient: Male, 60-year-old Final Diagnosis: Gas gangrene Symptoms: Pain Medication: — Clinical Procedure: Fasciotomy • surgical debridement Specialty: Critical Care Medicine • Infectious Diseases Objective: Rare disease Background: Clostridial myonecrosis, also known as gas gangrene, is a highly lethal necrotizing soft tissue infection. While commonly associated with trauma, clostridial myonecrosis may be the result of parenteral injection of medications. Epinephrine is the most commonly reported medication leading to gas gangrene. Case Report: A 60-year-old man presented to the Emergency Department (ED) with “the worst pain in his life” to the right thigh near the site at which he auto-injected epinephrine after multiple bee stings 10–11 h prior to arrival. Initial heart rate was 112 beats/min but all other vital signs were unremarkable at presentation. Due to extreme pain, a computed tomography (CT) scan was ordered, revealing prominent gas within the anterior compartment of the right thigh, mostly involving the vastus lateralis and rectus femoris, suggesting necrotizing fasciitis. Antimicrobials were initiated immediately and the patient was taken for surgical debridement within 70 min after obtaining the CT results. Clostridium perfringens was cultured from the patient’s tissue. After several surgical debridement’s, appropriate antimicrobial therapy, supportive care, and wound care, the patient’s limb remained intact and he was discharged after 11 days. Conclusions: With millions of epinephrine auto-injectors prescribed yearly in the United States, awareness of clostridial gas gangrene following epinephrine auto-injection for the provider may help guide decision-making in patients presenting with extreme pain, redness, or swelling near the injection site after epinephrine injection. |
| Databáze: | OpenAIRE |
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