Home Gas gangrene (myonecrosis)

Gas gangrene (myonecrosis)

Defining Characteristics

Rapidly progressive, toxemic infection in previously injured muscle (blunt trauma), edema, crepitus (gas bubbles), brown bullae; abrupt pain

Disease Development

Blunt trauma causes non-viable tissue to lose blood supply, creating anaerobic environment for spore-forming, gram positive rod bacteria to infect injured muscle

Potential Causes

Clostridium perfringens
C. novyi
C. histolyticum

Epidemiology

Historically seen with war injuries but now associated w. blunt trauma

Risk factors

h/o severe penetrating trauma or crush injuries

Lab/Imaging

XR shows edema and gas in soft tissue

Conventional Treatment

Aggressive surgical debridement
PCN + clindamycin

Complications

Spontaneous (hematogenous) gangrene from Clostridium septicum in pts with GI
malignancies or neutropenia