G204

Gram – Wound (knee): 3+ (6-10 /oif) neutrophils –3+ (11-50/oif) gram positive bacilli (Clostridium perfringens) – Shipped February 08, 2021

HISTORY

A simulated wound swab sample collected from 23 year old car crash victim with knee wound was sent to category A and C1 laboratories. Participants were expected to report the presence of neutrophils and gram positive bacilli.

MAIN EDUCATIONAL POINTS from G204

  1. The direct examination of a Gram-stained smear of the wound is vital to support early clinical diagnosis of clostridial myonecrosis (gas gangrene).
  2. Anaerobes are easily over decolorized in the Gram stain. However, the distinctive morphology of uniform, large box-car-shaped rods should raise suspicions of C. perfringens and consideration should be given to repeating the stain.

Full critique (PDF)

Posted in Clinical Bacteriology Results, critiques, Gram