Gas gangrene

Alternative names:

tissue infection - clostridial; gangrene - gas; clostridial myonecrosis; clostridial infection of tissues

Symptoms:

initial symptoms:

• moderate to severe pain around a skin injury
• progressive swelling around a skin injury
• moderate to low fever
• skin color initially pale, later dusky to highly discolored
• skin color progressing to dark red or purple
• vesicle (blister) formation, coalescent (combine into large blisters)
• blisters filled with brown-red fluid
• drainage from the tissues, foul-smelling brown-red or bloody fluid (serosanguineous discharge)
• increased heart rate (tachycardia)
• sweating
• subcutaneous emphysema

Note: Symptoms usually begin suddenly and rapidly and progressively worsen.

Signs and tests:

Shock may be present, as evidenced by general pallor, cold extremities, low blood pressure, and rapid heart rate. Air in the tissues (crepitus) may be felt. Infection involving the entire body (systemic toxicity or sepsis) may develop. Yellow skin color associated with the excessive breakdown of blood cells (jaundice) is possible.

• A Gram stain of fluid from the infected area shows Gram positive rods and spoke formation.
• An anaerobic tissue and/or fluid culture reveals Clostridium species.
• An X-ray, CT scan, or MRI of the area shows gas in the tissues.

Update Date: 02/09/00
Updated by: J. Gordon Lambert, MD, Associate Medical Director, Utah Health Informatics and adam.com editorial