This 3 year old boy, with acute lymphocytic leukemia and a falling neutrophile count following high dose cytotoxic chemotherapy, developed tender edematous confluent rapidly progressive red and purple patches on his right buttock, scrotum, penis, perineum, groin and lower abdominal wall. The areas continue to spread despite broad spectrum antibiotic treatment. Computed tomography of the abdomen and pelvis revealed soft tissue air in the right buttock. At surgery a large abscess in the right gluteal muscle was drained and a Gram stain showed Gram positive rods suggestive of Clostridium. One day after surgery the edema, tenderness, and erythema were markedly improved.
tender edematous red and purple patches and plaques