# Clostridium septicum Gas Gangrene Complicated by Cerebral Air Embolism

## TL;DR

An elderly man with diabetes developed a rare C. septicum infection leading to gas gangrene and a fatal cerebral air embolism.

## Contribution

This case highlights the rare but severe complication of cerebral air embolism caused by Clostridium septicum.

## Key findings

- C. septicum was isolated from blood and tissue samples in a patient with gas gangrene and cerebral air embolism.
- The patient's condition deteriorated despite initial treatment, resulting in death.
- The case underscores the importance of rapid diagnosis and treatment in necrotizing infections.

## Abstract

Clostridium septicum (C. septicum) is a rare cause of necrotizing soft tissue infection and is most commonly associated with spontaneous infections in patients with underlying gastrointestinal pathology. In rare cases, it can affect other organs or cause air embolism. We report the case of an 85-year-old man with diabetes mellitus who initially presented with fever and later developed inflammatory signs in the left upper limb and chest wall. CT revealed signs of gas gangrene in these locations. Due to the onset of prostration and motor aphasia, a brain CT scan was performed and showed an area of infarction in the left anterior cerebral artery territory with gas bubbles inside, likely secondary to air embolism. Empirical antibiotic therapy was initiated, and the patient underwent surgical debridement. C. septicum was isolated from both blood cultures and debrided tissue samples. Despite an initially satisfactory clinical response, the patient ultimately passed away on the seventeenth day of hospitalization. In necrotizing soft tissue infections, rapid diagnosis and treatment are critically important due to their high morbidity and mortality rates. In survivors of C. septicum infection, colorectal cancer should always be ruled out.