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Had a patient with gas on x ray. Took repeat x ray 8 hours later, no change in gas. Gas was located at ulcer site of foot, and several cm proximal to ulcer site. No crepitus, no fluctuance. WBC 7. No fever. Clinically the foot didn't look like your typical gas patient. Pt. may be immunocompromised from DM, hep C, etc. Local wound swab grew Proteus Mirabilis, which also grew in blood culture. Infectious Disease says not all gas on x ray is emergent, that Proteus can grow gas, but it isn't toxic like C. Perfringens.
I've never heard this before, always assumed that any gas on X ray was emergency surgery. Any thoughts? Thanks.
I've never heard this before, always assumed that any gas on X ray was emergency surgery. Any thoughts? Thanks.