Clostridial myonecrosis

Disease class: Bacterial infection 

Also known as 

• Gas gangrene.

This is a surgical emergency.

 

Pathogens

• Clostridium perfringens

 

Signs

• Oedema
• Red-purple-black discolouration
• Loud crepitus
• Black necrotic bullae

 

Pathophysiology

This is caused by Clostridium perfringens alpha toxin secreted by bacteria. This exotoxin causes myonecrosis (muscle death). The infection spreads rapidly as the bacteria divide and tissues disintegrate.

The process produces a large amount of gas which accumulates under the subcutaneous tissues. Subcutaneous emphysema and many large bullae develop. In one clinical case, the gas composition was reported as 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen, and 16.1% oxygen.

 

See also

• Necrotising fasciitis