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Gas gangrene
Tissue infection - Clostridial; Gangrene - gas; Myonecrosis; Clostridial infection of tissues; Necrotizing soft tissue infection
Gas gangrene is a potentially deadly form of tissue death (gangrene) .
Causes
Gas gangrene is most often caused by bacteria called Clostridium perfringens. It also can be caused by group A streptococcus, Staphylococcus aureus, and Vibrio vulnificus .
Gangrene
Gangrene is the death of tissue in part of the body.
Clostridium is found nearly everywhere. As the bacteria grow inside the body, it makes gas and harmful substances (toxins) that can damage body tissues, cells, and blood vessels.
Gas gangrene develops suddenly. It usually occurs at the site of trauma or a recent surgical wound. In some cases, it occurs without an irritating event. People most at risk of gas gangrene usually have blood vessel disease ( atherosclerosis , or hardening of the arteries), diabetes, or colon cancer.
Atherosclerosis
Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These ...
Symptoms
Gas gangrene causes very painful swelling. The skin turns pale to brownish-red. When the swollen area is pressed, gas can be felt as a crackly sensation (crepitus). The edges of the infected area grow so quickly that changes can be seen over minutes. The area may be completely destroyed.
Symptoms include:
-
Air under the skin (
subcutaneous emphysema
)
Subcutaneous emphysema
Subcutaneous emphysema occurs when air gets into tissues under the skin. This most often occurs in the skin covering the chest wall or neck, but can...
Read Article Now Book Mark Article - Blisters filled with brown-red fluid
-
Drainage from the tissues, foul-smelling brown-red or bloody fluid (
serosanguineous
discharge)
Serosanguineous
Serosanguineous means containing or relating to both blood and the liquid part of blood (serum). It usually refers to fluids collected from or leavi...
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Increased heart rate (
tachycardia
)
Tachycardia
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
ImageRead Article Now Book Mark Article - Moderate to high fever
- Moderate to severe pain around a skin injury
- Pale skin color, later becoming dusky and changing to dark red or purple
- Swelling that worsens around a skin injury
- Sweating
-
Vesicle
formation, combining into large blisters
Vesicle
A vesicle is a small fluid-filled blister on the skin.
ImageRead Article Now Book Mark Article - Yellow color to the skin (jaundice)
If the condition is not treated, the person can go into shock with decreased blood pressure (hypotension), kidney failure , coma, and finally death.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Exams and Tests
The health care provider will perform a physical exam. This may reveal signs of shock.
Tests that may be done include:
- Tissue and fluid cultures to test for bacteria including clostridial species
- Blood culture to determine the bacteria causing the infection
- Gram stain of fluid from the infected area
-
X-ray
,
CT
scan, or
MRI
of the area may show gas in the tissues.
X-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray particles through the body. The im...
ImageRead Article Now Book Mark ArticleCT
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
ImageRead Article Now Book Mark ArticleMRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
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Treatment
Surgery is needed quickly to remove dead, damaged, and infected tissue.
Surgical removal (amputation) of an arm or leg may be needed to control the spread of infection. Amputation sometimes must be done before all test results are available.
Antibiotics are also given. These medicines are given through a vein (intravenously). Pain medicines may also be prescribed.
In some cases, hyperbaric oxygen treatment may be tried.
Hyperbaric oxygen treatment
Hyperbaric oxygen therapy uses a special pressure chamber to increase the amount of oxygen in the blood.
Outlook (Prognosis)
Gas gangrene usually begins suddenly and quickly gets worse. It is often deadly.
Possible Complications
Complications that may result include:
- Coma
-
Delirium
Delirium
Delirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.
ImageRead Article Now Book Mark Article - Disfiguring or disabling permanent tissue damage
- Jaundice with liver damage
- Kidney failure
- Shock
- Spread of infection through the body (sepsis)
-
Stupor
Stupor
Decreased alertness is a state of reduced awareness. A coma is a state of decreased alertness from which a person cannot be awakened. A long-term co...
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When to Contact a Medical Professional
This is an emergency condition requiring immediate medical attention.
Call your provider if you have signs of infection around a skin wound. Go to the emergency room or call the local emergency number (such as 911), if you have symptoms of gas gangrene.
Prevention
Clean any skin injury thoroughly. Watch for signs of infection (such as redness, pain, drainage, or swelling around a wound). See your provider promptly if these occur.
References
Henry S. Extremity gas gangrene. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy . 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:742-745.
Onderdonk AB, Garrett WS. Gas gangrene and other Clostridium -associated diseases. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 248.
-
Gas gangrene - illustration
Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with underlying vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.
Gas gangrene
illustration
-
Gas gangrene - illustration
Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. It generally occurs at a wound or surgical site, causing painful swelling and destruction of involved tissue. Gas gangrene is rapidly progressive and often fatal.
Gas gangrene
illustration
-
Bacteria - illustration
Bacterial infections can lead to the formation of pus, or to the spread of the bacteria in the blood.
Bacteria
illustration
-
Gas gangrene - illustration
Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with underlying vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.
Gas gangrene
illustration
-
Gas gangrene - illustration
Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. It generally occurs at a wound or surgical site, causing painful swelling and destruction of involved tissue. Gas gangrene is rapidly progressive and often fatal.
Gas gangrene
illustration
-
Bacteria - illustration
Bacterial infections can lead to the formation of pus, or to the spread of the bacteria in the blood.
Bacteria
illustration
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
