Suspected Clostridial Myonecrosis Following a Crocodile Bite: A Deadly Encounter in a Resource-Limited Setting

Abstract Gas-forming necrotising soft-tissue infections (NSTIs) are rapidly progressive surgical emergencies associated with substantial morbidity and mortality. Although clostridial myonecrosis is the classic cause, polymicrobial gas-forming infections following traumatic aquatic injuries are increasingly recognised. Crocodile bites are particularly high-risk injuries because they combine extensive tissue destruction, environmental contamination, and inoculation with polymicrobial oral flora. We describe a 42-year-old patient who presented in hypovolemic shock two hours following a crocodile bite to the right lower limb, resulting in an open femur fracture. Emergency debridement was performed shortly after admission. Within hours postoperatively, the patient developed rapidly progressive pain, tissue discolouration, bullae formation, extensive crepitus, and radiographic soft-tissue gas extending proximally to the abdominal wall. He succumbed to septic shock despite broad-spectrum antibiotics and intensive supportive care. This case highlights the fulminant nature of gas-forming NSTI, the necessity of early recognition, and the high infectious risk associated with crocodile-related injuries.