Gas Gangrene

Clostridium perfringens is a large,spore-forming, gram-positive, nonmotile rod with square ends.

-It is commonly found in the environment and intestines. 

-It produces α-toxin, a phospholipase, which causes hemolysis, tissue destruction, and shock.

-It can cause wound infections, soft tissue infections, and gas gangrene

-knife or gunshot wounds, vehicular accident wounds, surgical wounds are particularly susceptible to this bacteria 

Symptoms & Signs 

Sudden onset of excruciating pain at the affected site, brawny edema, tissue death, foul-smelling serosanguineous discharge, blisters with clear to purplish fluid, gas bubbles, crepitance, fever, hypotension, shock, and multiorgan failure 

Diagnosis: clinical history, physical examination, surgical exploration, 

Gram’s staining, and histopathologic examination. Biopsy shows gram-positive or gram-variable rods and a paucity of leukocytes. Radiographs may show gas bubbles in the tissues 

Treatment 

Gas gangrene is an emergency and requires immediate surgical debridement (excision of all devitalized tissue); administration of penicillin and clindamycin for 10–14 days

Hyperbaric oxygen therapy is controversial .

  1. What is the most effective method of prevention of gas gangrene? Surgical debridement of traumatic injuries 
  2. What is the most common adverse effect of HBO treatment? Middle ear barotrauma