Gas Gangrene
Gas gangrene is a life-threatening infection of muscle tissue caused mainly by the anaerobic bacterium. The hallmarks of this disease are rapid onset of myonecrosis, gas production, and sepsis. Several thousand cases occur in the United States every year. Clostridium perfringens and several other Clostridium species. Gangrene is the term for the death of tissue. Gas gangrene is a fast-spreading clostridial infection of muscle tissue that quickly leads to death if untreated.Bacteria such as Clostridia which infect wounds may release enzymes that destroy tissue. Such bacteria usually produce gas in the tissue and lead to gas gangrene.The bacteria produce gas that becomes trapped in the infected tissue.It usually develops after trauma or surgery, although spontaneous infections can occur-usually in people with colon cancer or leukemia. Surgery on the colon and gallbladder are the procedures most likely to be complicated by gas gangrene. High-risk injuries are those that become contaminated with dirt and vegetable matter or that contain crushed and dead tissue. People with open fractures and frostbite are also particularly susceptible to gas gangrene. Gas gangrene is Clostridial spores are widely distributed in the environment.and May enter traumatic or surgical wounds and Contamination may also occur from patients own faecal flora. Bacteria in the Clostridium species are gram-positive, spore-forming, anaerobic rods normally found in soil and the gastrointestinal tract of humans and animals. They most often cause disease in the setting of trauma or surgery but can also occur spontaneously in the absence of definite risk factors or exposures. Not all wounds contaminated with clostridia develop gas gangrene; the myonecrosis seems to only develop when sufficient devitalized tissue is present to support anaerobic metabolism.
Spontaneous gas gangrene is most often caused by hematogenous spread of Clostridium septicum from the gastrointestinal tract in patients with colon cancer. The organism enters the blood via a small break in the gastrointestinal mucosa and subsequently seeds muscle tissue. Unlike Clostridium perfringens, Clostridium septicum is aerotolerant and can infect normal tissues.In both traumatic gas gangrene and spontaneous gas gangrene, exotoxin, not bacterial proliferation, is responsible for the rapid progression of infection. Exotoxin hydrolyses cell membranes, causes tissue necrosis by inducing occlusive microvascular thrombosis, and has direct cardiodepressive effects. Products of tissue breakdown, including creatine phosphokinase, myoglobin, and potassium, cause secondary toxicity. Other bacteria are also capable of producing gas, and nonclostridial organisms have been isolated in 60-85% cases of gas gangrene. A recent clinical series on gas gangrene demonstrated a predominance (83.3%) of aerobic gram-negative bacilli in wound cultures compared with anaerobic gram-positive bacilli.
Causes of Gas Gangrene
Common causes of Gas Gangrene
- Infection.
- Toxins.
- Shock.
- Jaundice.
- Haemolysis.
- Acute renal failure.
- Leaking of the blood vessels.
- Unwell.Burns.
- Chronic.
- Alcoholism.
- Corticosteroid.
- Gastrointestinal.
- Malignancy.
- Hypoalbuminemia.
Symptoms of Gas Gangrene
Common symptoms of Gas Gangrene
- Sweating.
- Increased heart rate.
- Skin color initially pale.
- Fever.
- Altered level of consciousness.
- Sweet-smelling discharge.
- Haemorrhagic areas.
- Drainage from the tissues.
Treatment of Gas Gangrene
Common Treatment of Gas Gangrene
- Treatment in a high-pressure oxygen chamber is of uncertain value; moreover, such chambers are not readily available.
- Debridement and excision with amputation necessary in many cases. Antibiotics alone are not effective because they don't penetrate ischemic muscles enough to be effective.
- Hyperbaric oxygen therapy is used and acts to inhibit the growth of and kill the anaerobic.
- Prompt surgical removal of dead, damaged, and infected tissue is necessary. Amputation of an arm and leg may be indicated to control the spread of infection.
- Organisms are usually sensitive to penicillin.
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