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Gas Gangrene: Dr. Ehsanur Reza Shovan
Gas Gangrene: Dr. Ehsanur Reza Shovan
c.septicum
c.novyi
c. Perfringens
(mostly)
• They are present in the soil
and have also been
isolated from the human
gastrointestinal tract and
female genital tract.
• Non-clostridial gas-
producing organisms such
as coliforms have also
been isolated in 60–85% of
cases of gas gangrene.
vegetative
cells multiply
Spores Carbohydrates
germinate Fermentation
Anaerobic
PATHOGENESIS Gas production
In tissues
environment Incubation period is
1-7 days
Distension of
Toxemia and tissues
death Interfering
Blood supply
Ischemia/
gangrene
Pathogenesis
- Bacteria
- The toxins Examples of enzyme:
enters the (lecithinase) colagenases, proteases
broken skin or and enzyme and lipases
wound are produced
- These enzymes will
- Thebacteria are kill other host cell and
- Spores
are grow and ferment extend the anaerobic
produced the muscle environment
carbohydrate - Produce gases (nitrogen,
hydrogen sulphide and
- The bacteria
carbon dioxide)
present in the anaerobic - Crepitant tissue
circulation tissue present
system ( destroyed tissue)
Epidemiology
I
N
S
O
F
T
T
I
S
S
U
E
G
A
S
I
N
U
T
E
R
U
S
G
A
S
I
N
U
T
E
R
U
S
G
A
S
I
N
U
T
E
R
U
S
Prevention
• Cleaning the wound
• Avoid the contaminated material
• improve circulation in
patients with poor circulation
• antitoxin
Prevention
(1) Do a thorough wound toilet.
(2) In high risk wounds give the patient
penicillin 1.5 megaunits 4 hourly,
or tetracycline
Treatment
• No vaccine
10 megaunits of benzyl penicillin daily for 5
days as four 6 hourly doses.
Or
Tetracycline 0.5 g intravenously
or 1 g orally every 6 hours.