| Gas Gangrene |
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FEATURES Gas gangrene can cause Myonecrosis , gas production, and Sepsis . Progression to Toxemia and Shock is often very rapid. PATHOPHYSIOLOGY Gas gangrene is caused by Exotoxin producing Clostridial species (most often '' Clostridium Perfringens ''), which is mostly found in soil, and other Anaerobe s (e.g. '' Bacteroides '' and anaerobic Streptococci ). These environmental bacteria may enter the muscle through a wound and go on to proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case. TREATMENT Treatment is usually surgical Debridement and Excision with amputation necessary in many cases. Antibiotic s alone are not effective because they don't penetrate Ischemic Muscle s enough to be effective. However penicillin is given as an Adjuvant Treatment to surgery. In addition to surgery and antibiotics Hyperbaric Oxygentherapy (HBO) is used and acts to inhibit the growth of and kill the anaerobic C. perfringens. REFERENCES |
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