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
labimaging
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
