Dr. Arthur L. Boland: A 29-year-old man, an iron worker, whose condition was diagnosed as gas gangrene, was transferred from a local hospital; it was his first admission to Children's Hospital Medical Center. Two days earlier, when he had been struck by a rotating truck wheel, he sustained an open fracture of his right tibia and a wringer-type soft tissue injury of the leg. When he was admitted to the other hospital, the right foot was pulseless; however, circulation returned immediately upon closed reduction of the fracture in the accident room. The wounds were then debrided and closed primarily in the operating room, and the tibial fracture was held with a Lottes nail. He was treated with intravenous administration of aqueous potassium penicillin G, streptomycin, tetanus toxoid, and hyperimmune serum.
The patient's temperature was 104 F (40.0 C), 24 hours later, and the calf of his right leg was severely