Original communication| Volume 18, ISSUE 3, P369-377, September 1945

The occurrence of Bacillus histolyticus in accidental wounds without recognized specific infection

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      B. histolyticus was demonstrated in cultures taken from débrided tissues in 17 civil wounds. There were 7 compound fractures, 5 lacerations, 3 gunshot wounds, and 2 burns. These are believed to be the first records of B. histolyticus in connection with burns.
      Only 1 case, that of a compound fracture, proved fatal. This was a typical case of gaseous gangrene caused by B. perfringens and other bacteria. The typical lesions produced by pure infections of B. histolyticus were probably masked and were not recognized.
      All of the other patients recovered and the peculiar lesions of infection by B. histolyticus were not recognized in any case.
      Persistence of B. histolyticus in an infected wound was noted in one case of compound fracture of the leg as late as the twenty-fifth day, when the leg had to be amputated. Persistence to the thirty-seventh day was observed also in a case of multiple pistol shot wounds.
      The occurrence of B. histolyticus in wounds is regarded solely as an expression of its widespread occurrence in nature. If wounds are promptly and adequately débrided it rarely persists. If gaseous gangrene develops, the peculiar lesions produced by this organism in pure infections are likely to be masked and overlooked. It may persist in a mixed infection for twenty-five to thirty-seven days without giving any clinical indication of its presence.
      The comparatively infrequent demonstration of this organism in accidental wounds probably gives an erroneous conception of the actual frequency of its occurrence owing to the fact that it is so easily overlooked in a bacteriologic examination of a mixed infection.
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