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 ass ociated 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 aplas tic anemia who developed gas gangrene of his right leg due to Clostridium s epticum. 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 ref ractory neutropenia, open wound, and high likelihood of dying from his infe ction, we proceeded with an HLA-matched sibling bone marrow transplantation (BMT) three weeks following his amputation. The transplanted marrow succes sfully engrafted, the patient fully recovered and was discharged 90 days af ter the onset of illness.