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Case report
peer-reviewed

Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat



Abstract

Gas gangrene is one of the most serious infections of traumatic and surgical wounds. The importance lies in the fact that, if not managed at the right time, the condition is fatal. Though perianal cellulitis and gangrene are commonly reported in immunocompromised patients, we report the case of a patient with gas gangrene involving only the anal canal extending to the rectum, a rare presentation to be reported in literature. 

An 18-year-old lady, a patient of aplastic anaemia - immunodeficiency, developed gas gangrene of the anal canal possibly due to faecal contamination of anal fissures. The patient was managed with surgical debridement and intravenous antibiotics. 

The clinical manifestations of gas gangrene are due to the liberation of toxins by Clostridium perfringens. The infection spreads rapidly and results in necrosis and devitalisation of tissues, unless intervened surgically.

The clinical manifestations are more rapid and a high index of suspicion is needed for the diagnosis.



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Case report
peer-reviewed

Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat


Author Information

Sundaramurthi Sudharsanan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Chellappa Vijayakumar

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Kumar Manish

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

TP Elamurugan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Ali S. Manwar Corresponding Author

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat


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Case report
peer-reviewed

Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat

  • Author Information
    Sundaramurthi Sudharsanan

    Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

    Chellappa Vijayakumar

    Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

    Kumar Manish

    Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

    TP Elamurugan

    Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

    Ali S. Manwar Corresponding Author

    Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: July 13, 2017

    DOI

    10.7759/cureus.1469

    Cite this article as:

    Sudharsanan S, Vijayakumar C, Manish K, et al. (July 13, 2017) Anal Canal Gas Gangrene in Aplastic Anaemia: Rare yet Lethal Entity - A Caveat. Cureus 9(7): e1469. doi:10.7759/cureus.1469

    Publication history

    Received by Cureus: June 15, 2017
    Peer review began: June 16, 2017
    Peer review concluded: June 20, 2017
    Published: July 13, 2017

    Copyright

    © Copyright 2017
    Sudharsanan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Gas gangrene is one of the most serious infections of traumatic and surgical wounds. The importance lies in the fact that, if not managed at the right time, the condition is fatal. Though perianal cellulitis and gangrene are commonly reported in immunocompromised patients, we report the case of a patient with gas gangrene involving only the anal canal extending to the rectum, a rare presentation to be reported in literature. 

An 18-year-old lady, a patient of aplastic anaemia - immunodeficiency, developed gas gangrene of the anal canal possibly due to faecal contamination of anal fissures. The patient was managed with surgical debridement and intravenous antibiotics. 

The clinical manifestations of gas gangrene are due to the liberation of toxins by Clostridium perfringens. The infection spreads rapidly and results in necrosis and devitalisation of tissues, unless intervened surgically.

The clinical manifestations are more rapid and a high index of suspicion is needed for the diagnosis.



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Create a free account to continue reading this article.

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Sundaramurthi Sudharsanan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Chellappa Vijayakumar

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Kumar Manish

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

TP Elamurugan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Ali S. Manwar

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

For correspondence:
alismanwar@gmail.com

Sundaramurthi Sudharsanan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Chellappa Vijayakumar

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Kumar Manish

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

TP Elamurugan

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Ali S. Manwar

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

For correspondence:
alismanwar@gmail.com