A CASE OF GAS GANGRENE ASSOCIATED WITH DIABETES MELLITUS TREATED BY OXYGEN AT HIGH PRESSURE

We report a case of non-clostridial gas gangrene (NCGG) with untreated diabets mellitus, which was successfully treated by oxygen at high pressure (OHP). A 39-year-old man had been diagnosed as diabetes mellitus some years before, but had not been treated. On April 1994 he was admitted to another hospital because of fever elevation and a swelling of the left foot. Administration of antibiotics was not effective nd a plain roentgenogram revealed gases in the subcutaneous tissue and muscularis. Therefore, he was referred to the hospital. Immediately after admission, adequate control of serum glucose, random skin cutting, administration of antibiotics and prostaglandin E1 and OHP were carried out. Gases disappeared after OHP and he recovered with conservative treatment without amputation of the left foot, though it took a long time. A diagnosis of NCGG was made because Peptostreptococcus anaerobius was isolated on admission. OHP is effective for the treatment of NCGG as this case suggested. Therefore, OHP should be employed aggressively and we have to take more careful attitude to the amputation of the affected limb in the patients with diabetes mellitus.