M161-4

Deep wound (Toe): Clostridium perfringens – Shipped May 16, 2016

HISTORY

A simulated deep toe wound sample collected from a 50-year old diabetic patient with a possible gangrenous toe was sent to category A laboratories. Anaerobic culture was required.

Participants were expected to isolate and report Clostridium perfringens.

MAIN EDUCATIONAL POINTS from M161-4

1. The double zone hemolysis and colonial morphology on anaerobic blood agar, Brucella agar or PEA agar is suggestive of C. perfringens.
2. While anaerobic gram positive bacilli is technically correct, correlation of this result with a Gram-stain result that has gram positive rods suggestive of Clostridium would provide the clinician with valuable information that could save the patient’s limb or life.

Full critique (PDF)