A case of gas gangrene arising as a complication of exploratory ureterotomy in a patient with chronic bilateral renal infection is described. The bacteriological diagnosis was established on the second day after onset; a toxigenic strain of type A was isolated from the wound. was isolated from the wound and from the patient's bloodstream.

Combined therapy included prompt surgical treatment and repeated local instillations of HO and a saline solution containing 1000 IU penicillin per ml. Parenteral antibiotic therapy included 20 M.units of penicillin daily, and pyrrolidinomethy 1 tetracycline and spiramycin. A dose of 10,000 units of antitoxin was given intravenously in a polyvalent clostridial antitoxic serum, followed by 30,000 units as monovalent serum when the diagnosis was confirmed.

The patient's condition improved dramatically within a few hours of the start of the combined therapy and recovery was complete within 8 days.

The pathogenesis, diagnosis and current methods of treatment of gas gangrene are discussed, with special reference to post-operative gas gangrene.


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