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Gas Gangrene (Clostridial Myonecrosis) - Coggle Diagram
Gas Gangrene (Clostridial Myonecrosis)
Epidemiology
Infection of skeletal muscle
Caused by
Clostridium
Gram + spore-forming anaerobic bacilli
Traumatic
Clostridium perfringens
Spontaneous/non-traumatic
Clostridium septicum
Associated with bowel cancer
Clostridial toxins
Alpha toxin
Theta toxin
Pathogenesis
Necrosis + gas production
Traumatic
(most common)
Contiguous spread
Deep injury
Penetrating into muscle
Contamination by soil
Foreign material containing spores/organisms
Vascular compromise
Anaerobic environment
Spontaneous/non-traumatic
Haematogenous spread
Bacteria from GIT to muscle
Intestinal abnormalities
Bowel cancer
Inflammatory bowel disease
Leukemia
Clinical Manifestations
Sudden onset excruciating pain at site
Change in skin color
Crepitus (gas formation)
Necrosis
Systemic features
Shock
Multiorgan failure
Death
Diagnosis
Diagnosed clinically
Surgical exploration
Tissue sample
Gram stain
Culture
Histopathology
Blood culture
CT/MRI
Look for gas
May feel gas on palpation
Treatment/Prevention
Emergency aggressive surgical debridement
IV antibiotics
Benzylpenicillin + Clindamycin
