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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).

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Gas gangrene
Gas gangrene
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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.

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 for gas gangrene usually have blood vessel disease (atherosclerosis, or hardening of the arteries), diabetes, or colon cancer.

Symptoms

Gas gangrene causes very painful swelling. The skin turns pale to brownish-red. When the swollen area is pressed, gas can be felt (and sometimes heard) 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:

If the condition is not treated, the person can go into shock with decreased blood pressure (hypotension), kidney failure, coma, and finally death.

Exams and Tests

The health care provider will perform a physical exam. This may reveal signs of shock.

Tests that may be done include:

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.

Outlook (Prognosis)

Gas gangrene usually begins suddenly and quickly gets worse. It is often deadly.

Possible Complications

Complications that may result include:

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.

Related Information

Necrotizing soft tissue infection
Anaerobic
Toxins
Necrosis
Vasoconstriction
Systemic
Stress and your health
Shock
Acute kidney failure
Decreased alertness
Delirium

References

Henry S, Cain C. Gas gangrene of the extremity. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:862-866.

Onderdonk AB, Garrett WS. Diseases caused by clostridium. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 246.

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Review Date: 11/9/2019  

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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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