Clostridial Myonecrosis Flashcards
Clostridial Myonecrosis
Gas Gangrene
Signs and Symptoms
1-dramatic
2- severe pain rapidly increases in infected wound
3- increase of swelling
4-thin bloody or brownish foul smelling fluid
5-skin over wound:
- stretched tight
- discolored patches that turn black as tissue dies
6-seriously ill but remains alert until late in illness when near death becomes delirious & goes into a coma
thin bloody or brownish foul smelling fluid :
(1) leaks from the wound
(2) may be frothy because of gas bubbles released by organisms
Causative Agent
Clostridium perfringens
two main factors leading to development:
(1) presence of dirt & dead tissue in wound
(2) long delays before wound treatment
Pathogenesis
1-two main factors leading to development:
- presence of dirt & dead tissue in wound
- long delays before wound treatment
2-cannot infect healthy tissue
BUT grows easily in poorly oxygenated & dead tissue
3-alpha (α) toxin :
causes cell lysis
4-collagenase and hyaluronidase:
break down host tissue
5-as bacterial cells multiply, they ferment tissue breakdown products :
-release of large amounts of hydrogen & carbon dioxide
release of large amounts of hydrogen & carbon dioxide would :
1- gases accumulate in tissue then increase pressure
2-without surgical treatment, large amounts of toxins diffuse into bloodstream then destroy RBCs tissue capillaries
3- systemic involvement leads to wide-scale cytokine release then shock & organ failure
conditions with decreased blood flow at increased risk:
(1) arteriosclerosis
(2) diabetes
Prevention
-prompt cleaning of wound
- debridement of dead tissue from wound
Location :
a. widespread in soil
b. dirt contamination of wounds
c. common in intestinal tract of animals & humans
Treatment
prompt surgical removal of dead & infected tissue
- may need to amputate
high doses of antibiotics BUT:
(1) do Not diffuse well into dead tissue
(2) do Not inactivate toxin
