List local signs and symptoms.
Excruciating muscle pain
Massive edema with skin discoloration that progresses from bronze to red-purple to black and overlying bullae
Sweet and foul-smelling or nonodorous discharge produced by anaerobic metabolic products
Crepitus: Palpation reveals crackling of the skin due to gas production (skin emphysema)
Spreading infectio
List features of systemic toxicity.
Can progress to systemic infection within a few hours
Early signs
Fever
Tachycardia
Altered mental status
Late signs
Shock
Multi-organ failure
Hemolytic anemia
ARDS
Kidney and liver failure
What is a subtype of gas gangrene?
Sponteneous gas gangrene.
Which pathogen causes sponteneous gas gangrene?
most commonly caused by C. septicum
Describe the etiology of sponteneous gas gangrene.
typically a complication of an underlying disease, e.g., malignancy (e.g., colon carcinoma), diabetes, or immunosuppression —> In contrast to gas gangrene caused by C. perfringens, which is most commonly due to trauma.
Describe the pathophysiology of sponteneous gas gangrene.
Bacteria from the gastrointestinal tract spread hematogenously (due to, e.g., a gastrointestinal lesion or adenocarcinoma of the colon) and reach the muscle tissue.
Diabetes may cause functional neutropenia, which increases the risk of bacterial infection.
Describe the clinical features, diagnosis and treatment of sponteneous gas gangrene.
same as gas gangrene caused by C. perfringens
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