Non-traumatic clostridium infection: report of an unusual case with rapid progression and a paucity of clinical signs in a patient with type 1 diabetes.

The number of cases of non-traumatic, spontaneous clostridial gas gangrene is increasing, and is an area of major concern for awareness by doctors. The disease is associated with high mortality, and survival is directly related to rapid diagnosis and prompt institution of appropriate antibiotics, surgical debridement and hyperbaric oxygen therapy. The dilemma is that early diagnosis cannot be firmly made on clinical findings alone, as these may not appear until very late, as in our patient, jeopardising the chances of the patient's survival. Mortality increases substantially in the absence of surgical treatment. Therefore, it could be suggested here that early surgical evaluation is needed, which could help in timely diagnosis, in patients with pain out of proportion to clinical findings, especially when no other plausible cause could be found.