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Clostridial myonecrosis, anaerobic
infections, or necrotizing
infections
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- This disease is caused when the
bacteria in the family of Clostridium (e.g., Clostridium
perfringens) infects the body tissue. Clostridium bacteria
of this type can only live where there is little or no
oxygen (i.e., anaerobic conditions). This occurs in damaged
or injured tissues where the oxygen supply is low. It is
called "gas" gangrene because the Clostridium bacteria
release gas that causes swelling in the surrounding tissue.
- Trauma, Diabetes Mellitus,
old age, poor circulation, malignancies of blood cell line,
poor nutrition, decrease in number of neutrophils (a type
of white blood cell), diseases of the large intestine, and
chemotherapy are some of the predisposing risks and causes
of gangrene.
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- Sudden onset of pain in affected
area
- Heart racing
- Drop in blood pressure
- Fever
- Later as the infection
progresses:
- Feel severely ill
- Confusion
- Delirium
- Coma
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- Wound is foul smelling with a
brown/clear, blood-tinged discharge
- Wound swells and surrounding skin
is pale
- Skin eventually changes from pale
to dusky to dark and discolored, containing blood-filled
blisters
- Gas may be felt in the tissues
- Skin and eyes may turn
yellow
- Blood cells may hemolyze (burst)
- Increase in white blood cells
- Levels of muscle enzyme Creatine
Kinase are often elevated with destruction of muscle
tissue in gangrene.
- Anemia in severe cases
- X-Rays may show
gas
- Anaerobic culture will confirm
diagnosis (takes too long to come back, so treatment is
initiated immediately)
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- Penicillin intravenously
- If allergic to penicillin --
Clindamycin, Tetracycline, Flagyl, Cefoxitin, and
Chloramphenicol. All are theoretically (in vitro) active
against these Clostridia.
- Surgical debridement (removal of
contaminated tissue) of affected area (stops continued
spread)
- Other treatment options:
- Hyperbaric oxygen -- oxygen
forced into tissues in an oxygen chamber
- Polyvalent Gas Gangrene
anti-toxin
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- This is a life-threatening
emergency that can lead to rapid death. Seek emergency
medical treatment
immediately.
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- Other bacterial infections, such as E. coli, enterobacter, and other anaerobic organisms
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