Gram – Wound (knee): 3+ (6-10 /oif) neutrophils –3+ (11-50/oif) gram positive bacilli (Clostridium perfringens) – Shipped February 08, 2021
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
- The direct examination of a Gram-stained smear of the wound is vital to support early clinical diagnosis of clostridial myonecrosis (gas gangrene).
- 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.