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


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

risk factors

h/o severe penetrating trauma or crush injuries


XR shows edema and gas in soft tissue

conventional treatment

Aggressive surgical debridement
PCN + clindamycin


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