Gas gangrene is rare in the United States. The condition is most often caused by a bacteria called Clostridium perfringens. However, it also can be caused by Group A streptococcus. Staphylococcus aureus and Vibrio vulnificus can cause similar infections.
Clostridium is found most everywhere. As the bacteria grow inside the body, it makes gas and harmful substances (toxins) that can damage body tissues, cells, and blood vessels.
Gas gangrene develops suddenly. It usually occurs at the site of trauma or a recent surgical wound. About 1 in 5 cases occur without an irritating event. Patients most at risk for this usually have underlying blood vessel disease (atherosclerosis or hardening of the arteries), diabetes, or colon cancer.
Gas gangrene causes very painful swelling. The skin turns pale to brownish-red. If you press on the swollen area with your fingers, you may feel gas as a crackly sensation. The edges of the infected area grow so quickly that changes can be seen over a few minutes. The area may be completely destroyed.
Note: Symptoms usually begin suddenly and quickly worsen.
If the condition is not treated, the person can develop shock with decreased blood pressure (hypotension), kidney failure, coma, and finally death.
Signs and tests
The health care provider will perform a physical exam. This may reveal signs of shock.
Tests that may be done include:
Tissue and fluid cultures to test for Clostridium bacteria
Blood culture to determine the bacteria causing the infection
Gram stain of fluid from the infected area
X-ray, CT scan, or MRI of the area may show gas in the tissues.
Surgery is needed quickly to remove dead, damaged, and infected tissue. This is called debridement.
Surgical removal (amputation) of an arm or leg may be needed to control the spread of infection. Amputation sometimes must be done before all test results are available.
You will also be given antibiotics, usually penicillin-type and clindamycin. These medicines will be given through a vein (intravenously). Doctors have tried hyperbaric oxygen for this condition, with varying degrees of success. Pain medicines may also be prescribed.
Gas gangrene usually begins suddenly and quickly gets worse. It is often deadly.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.