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glossary:gas_gangrene

(1)Gas gangrene is a severe form of gangrene (tissue death) usually caused by Clostridium perfringens (see also necrotizing subcutaneous infection ). It can also be from Group A Streptococcus. Staphylococcus aureus and Vibrio vulnificus can cause similar infections.

Alternative Names: Tissue infection - Clostridial; Gangrene - gas; Myonecrosis; Clostridial infection of tissues

Causes, incidence, and risk factors: Gas gangrene occurs as a result of infection with Clostridium bacteria that, under anaerobic (low oxygen) conditions, produce toxins that cause tissue death and associated symptoms. Gas gangrene is rare, with only 1,000-3,000 cases yearly in the U.S.

Gas gangrene generally occurs at the site of trauma or a recent surgical wound. About a third of cases occur spontaneously. Patients who develop this disease spontaneously often have underlying blood vessel disease (atherosclerosis or hardening of the arteries), diabetes, or colon cancer.

The onset of gas gangrene is sudden and dramatic. Inflammation begins at the site of infection as a pale-to-brownish-red and extremely painful tissue swelling. Gas may be felt in the tissue as a crackly sensation when the swollen area is pressed with the fingers. The edges of the infected area expand so rapidly that changes are visible over a few minutes. The involved tissue is completely destroyed.

Clostridium bacteria produce many different toxins, four of which (alpha, beta, epsilon, iota) can cause potentially fatal syndromes. In addition, they cause tissue death ( necrosis ), destruction of blood (hemolysis), local decrease in circulation ( vasoconstriction ), and leaking of the blood vessels (increased vascular permeability).

These toxins are responsible for both the local tissue destruction and the systemic symptoms (the other symptoms that occur throughout the body).

Systemic symptoms develop early in the infection. These consist of sweating, fever, and anxiety . If untreated, the individual develops a shock -like syndrome with decreased blood pressure (hypotension), kidney failure , coma , and finally death.

(2)Gas Gangrene also called is Clostridial and Myonecrosis. It is caused by Clostridium perfringens(ecrotizing subcutaneous infection). This bacteria is belong to Group A Streptococcus. Clostridium bacteria is produce toxins and it cause tissue death and associated symptoms. It generally occurs at a wound or surgical site, causing painful swelling and destruction of involved tissue. Other common clostridial species that cause gas gangrene include Clostridium bifermentans, Clostridium septicum, Clostridium sporogenes, Clostridium novyi, Clostridium fallax, Clostridium histolyticum, and Clostridium tertium. These environmental bacteria may enter the muscle through a wound and go on to proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical caseGas gangrene is rapidly progressive and often fatal. Bacteria in the Clostridium species are gram-positive, spore-forming, anaerobic rods normally found in soil and the gastrointestinal tract of humans and animals.

Gangrene is devided in four Types. Premary is Dry gangrene. If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a dry gangrene. The early signs of dry gangrene are a dull ache and sensation of coldness in the area, along with pallor of the flesh. If caught early, the process can sometimes be reversed by vascular surgery. Second is Internal gangrene it section is a stub.In this gangrene the tissues become white. It is located inside the body, usually after surgery or trauma. Also called “white gangrene”.Third is Wet gangrene like in dry gangrene, the blood flow is interrupted, but there is also a bacterial infection. Due to liquefactive necrosis, liquid is released and last is Gas gangrene. Gas gangrene is a bacterial infection that produces gas within tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. Treatment is usually surgical debridement and excision with amputation necessary in many cases. Antibiotics alone are not effective because they do not penetrate ischemic muscles sufficiently. However, penicillin is given as an adjuvant treatment to surgery.

Causes of Gas Gangrene

1.Clostridium perfringens(bacteria ).

2.Atherosclerosis

3.Surgery

4.Trauma

5.Gastrointestinal malignancy

6.Hypoalbuminemia

7.Chronic alcoholism

8.Diabetes

Symptoms of Gas Gangrene

1.Moderate to severe pain around a skin injury

2.Progressive swelling around a skin injury

3.Moderate to high fever

4.Sweating

5.Increased heart rate (tachycardia)

Treatment of Gas Gangrene

1.Treatment is usually debridement and excision with amputation necessary in many cases.

2.Antibiotics are not effective but penicillin is given as an adjuvant treatment to surgery.

3.Hyperbaric oxygen therapy (HBOT) is used and acts to inhibit the growth of and kill the anaerobic C. perfringens.

4. Analgesics may be required to control pain.

glossary/gas_gangrene.txt · Last modified: 2012/10/16 14:40 (external edit)