Gas gangrene is a condition where anaerobic bacteria release toxins that cause tissue death, and if not treated can be fatal. It usually occurs at trauma and wound sites.
Clostridium Perfringens Gas Gangrene and More
Gas gangrene is typically caused by the Clostridium bacteria. These are normal constituents of human gut microflora and in low oxygen conditions some strains can release an exotoxin which can damage tissues, cells, and blood vessels. There are four types of toxin - alpha, beta, epsilon, and iota - and the most common causative bacterium is C. perfringens. Other Clostridium species that can cause gas gangrene include Clostridium bifermentans, Clostridium septicum, Clostridium sporogenes, and Clostridium tertium.
Other bacteria that can also cause the severe infection include Group A Streptococcus and Staphylococcus aureus.
Gas gangrene is typically an infection of muscle tissue and a characteristic sign of infection is the presence of blisters that bubble with gas near infected areas. There are fewer than 3,000 cases in the United States annually.
Gas Gangrene Symptoms
Gas gangrene usually occurs at an injury site or at the site of a recent surgical wound. The onset of gas gangrene is rapid and symptoms include: -
- Air under the skin
- Blisters containing a brown-red fluid
- Increased heart rate
- Moderate to high fever
- Progressive swelling around a skin injury
- Moderate to severe pain around the site of an injury
If you were to press carefully on the swollen tissue you would feel a crackly sensation which is the gas underneath.
Gas Gangrene Treatments
Gas gangrene spreads rapidly and the only effective treatment is surgical excision of the dead tissue, which may sometimes mean limb amputation. Intravenous use of antibiotics can be effective if used early enough, and hyperbaric oxygen treatments have had mixed results. There are currently no vaccines that can prevent clostridial infections, but they can be prevented by the thorough cleaning of wounds and the removal of foreign matter and dead tissue from wounds.
Have there been any Historical Outbreaks of Gas Gangrene?
Gas gangrene rose to prominence during World War I. The incidence amongst civilians was low but gas gangrene complicated 6% of open fractures and 1% of open wounds in military personal. That figure had gone down to 0.7% in World War II (Hoi Ho et al, 2009). The infections were caused when bacteria living in the soil entered wounds.
Other outbreaks of gas gangrene include an outbreak amongst injecting drug users in England, Ireland, and Scotland in 2000. The fatal agent was found to be Clostridium novyi type A.