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