Non-clostridial gas gangrene due to Anaerococcus tetradius following a cesarean section: A case report

A 25-year-old healthy woman was admitted to our hospital with fever and abdominal pain. Abdominal contrast-enhanced computed tomography revealed a fluid collection with foamy gas formation extending from both rectus abdominis muscles to the subcutaneous tissue. Antimicrobial therapy with meropenem (3 g/day), clindamycin (1800 mg/day), and daptomycin (300 mg/day) was initiated as empiric therapy. Subcutaneous abscess culture revealed gram-positive cocci, which was identified as Anaerococcus tetradius. Histopathological examination of the necrotic tissue showed skeletal muscle necrosis. On the basis of these findings, the patient was diagnosed with Non-Clostridial Gas Gangrene (NCGG) due to A. tetradius. We report a novel case of NCGG caused by A. tetradius following a cesarean section in an immunocompetent patient. Although A. tetradius has been detected in clinical specimens, cases of human infections are extremely rare. Clinicians should consider A. tetradius infection as a complication of a cesarean section.