Gas Gangrene: Causes, Symptoms & Diagnosis
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Gas Gangrene

What Is Gas Gangrene?

Highlights

  1. Gas gangrene is a rapidly progressing and potentially life-threatening form of tissue death, or gangrene.
  2. Gas gangrene is most commonly caused by a bacterial infection. Bacteria may get into an open wound and cause gas to form beneath the skin, leading to tissue death. In rare cases, the condition may occur as a result of poor circulation.
  3. Gas gangrene is a serious infection that must be treated immediately. Treatment usually consists of antibiotics or surgery.

Gangrene is the death of body tissue. Clostridial myonecrosis, a type of gas gangrene, is a fast-spreading and potentially life-threatening form of gangrene caused by a bacterial infection from Clostridium bacteria. The infection causes toxins to form in the tissues, cells, and blood vessels of the body. These bacteria will release toxins that cause tissue death and release a gas.

Most gangrene infections occur in situations where open wounds from an injury or surgery are exposed to bacteria. Non-traumatic gas gangrene, a more rare form of gas gangrene, can develop when blood flow to body tissues is compromised and bacteria gets inside. There is a greater risk in people who have a peripheral vascular disease, atherosclerosis, or diabetes mellitus.   

Gas gangrene can occur anywhere on the body, but it most commonly affects the arms or legs. Common symptoms include increased heart rate, fever, and air under the skin. Skin in the affected area also becomes pale and then later changes to dark red or purple. These symptoms usually develop six to 48 hours after the initial infection and progress very quickly. Treatment may include antibiotics and surgery to remove the dead tissue. Occasionally a hyperbaric oxygen chamber may be used. Surgery consists of debridement (removal of dead tissue) and sometimes amputation.

Gas gangrene is a rare condition. However, it can quickly become a life-threatening infection when it goes untreated. You should call 911 or go to the nearest emergency room right away if you are experiencing symptoms of gas gangrene.

What Are the Symptoms of Gas Gangrene?

Symptoms

Symptoms of gas gangrene often include:

  • fever
  • air under the skin
  • pain in the area around a wound
  • swelling in the area around a wound
  • pale skin that quickly turns gray, dark red, purple, or black
  • blisters with foul-smelling discharge
  • excessive sweating
  • increased heart rate
  • vomiting
  • yellow skin and eyes (jaundice) is a late sign

This condition spreads so rapidly that you can see obvious changes in the skin of the affected area in just a few minutes.

If you have symptoms of gas gangrene, call 911 or go to the emergency room immediately. Delaying treatment can lead to shock, kidney failure, and coma. The infection may even become life threatening within 48 hours of the onset of symptoms.

What Causes Gas Gangrene?

Causes

Gas gangrene is most commonly caused by the Clostridium perfringens bacterium. In some cases, it may be caused by group A Streptococcus bacteria. The infection occurs suddenly and spreads quickly.

Gas gangrene generally develops at a recent surgical or injury site. In rare cases, it may happen spontaneously, without an apparent cause.

Certain injuries have a higher risk of causing gas gangrene, including:

  • muscle injuries
  • severely damaged tissues
  • wounds that are very deep
  • wounds that are contaminated with stool or dirt, especially those that might occur on a farm

You are also at an increased risk for developing this condition if you have:

  • diabetes
  • arterial disease
  • colon cancer
  • frostbite
  • open fractures
  • used a contaminated needle to inject substances into your muscles

How Is Gas Gangrene Diagnosed?

Diagnosis

Your doctor can diagnose gas gangrene by performing a physical examination and ordering various tests. Diagnostic testing may include:

  • skin culture to test for the presence of Clostridium perfringens and other bacteria
  • blood tests to check for an abnormally high white blood cell count, which can indicate an infection
  • imaging tests, such as an routine X-ray, to visualize tissues and check for the presence of gas or special studies such as magnetic resonance imaging (MRI) or arteriogram
  • surgery to evaluate the spread of gas gangrene within the body

How Is Gas Gangrene Treated?

Treatment

Treatment for gas gangrene must begin immediately. Once a diagnosis is made, high doses of antibiotics will be administered intravenously, or through a vein. For more serious cases, it may be necessary to begin treatment before diagnostic tests are even performed. Dead or infected tissue will need to be surgically removed right away. Your doctor may also try to repair damaged blood vessels to boost blood flow to the affected area.

Damaged tissues can also be treated with a type of reconstructive surgery called a skin graft. During a skin graft, your doctor will remove healthy skin from an unaffected part of your body and attach it over the damaged area. This can help restore any skin damage caused by gas gangrene.

In severe cases of gas gangrene, amputation of a limb may be necessary to prevent the infection from spreading to the rest of your body. Once your wound has healed, you may be fitted with a prosthetic limb. This is an artificial limb that may be attached to the amputation site to replace the missing body part.

Some doctors and hospitals use hyperbaric oxygen therapy to treat gas gangrene. This type of therapy involves breathing pure oxygen in a pressurized chamber for about 90 minutes. You may receive two to three treatments per day. Hyperbaric oxygen therapy steadily increases the amount of oxygen in your blood, helping infected wounds to heal faster.

What Is the Outlook for Someone with Gas Gangrene?

Outlook

Gas gangrene is a very serious condition that often begins unexpectedly and progresses rapidly. The infection can quickly become life threatening when left untreated. However, your individual outlook will depend on your overall health, the severity of the infection, and the location of the infection. Potential complications include:

  • permanent tissue damage
  • jaundice
  • liver damage
  • kidney failure
  • shock
  • widespread infection
  • coma
  • death

The sooner gas gangrene is treated, the better the outcome. It’s critical to seek medical treatment as soon as you notice symptoms.

How Can Gas Gangrene Be Prevented?

Prevention

The best way to prevent gas gangrene is to practice proper hygiene. If you have an injury, make sure to clean the skin thoroughly and to cover the wound with a bandage. Contact your doctor at the first signs of infection. Signs of infection include redness, swelling, pain, and discharge. Your doctor will remove any foreign objects and dead tissue from the wound. It’s also important to take any prescribed antibiotics according to your doctor’s instructions. This will help lower your risk of developing an infection.

Making certain lifestyle changes can also help reduce your risk for gas gangrene. These include:

  • avoiding tobacco products
  • properly caring for any existing health conditions, such as diabetes or arterial disease
  • maintaining a healthy weight by exercising regularly and eating a healthful diet that largely consists of lean protein, vegetables, and whole grains

If you’re concerned about your risk for gas gangrene, talk to your doctor about other ways to prevent the infection. 

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