infectious diseases
Clostridial Soft Tissue Infections
Key Points
Rapidly progressing infection develops hours or days after an injury, particularly when crushing or penetrating trauma devitalizes tissue, creating an anaerobic environment. Clostridial cellulitis often causes minimal pain, but, typically, myositis and myonecrosis are painful; crepitance due to gas in tissues is common in all forms. Drain and debride wounds quickly and thoroughly. Give penicillin plusclindamycin. For extensive myonecrosis, consider hyperbaric oxygen therapy, but do not let it delay surgical treatment. 