Today I was called for an emergency-a woman with an injection abscess of the buttock. The patient had the abscess for several weeks after an injection for malaria. She looked terrible-wasted, pale, diaphoretic and tachycardic-a true emergency. Her buttock was grossly swollen, red and full of pus. 

Wound 1 day after I&D
When the patient was asleep I could examine the wound better. I could feel crepitus (air) in the tissues. When I cut the wound open, pus and air bubbled out-gas gangrene-a clostridial infection. This patient is critically ill and the situation is complicated by her being HIV positive. Even in the USA, this would be a challenging case.

We will see if she can survive.