Which of the following is not true of gas gangrene?
It is caused by clostridium perfringens
Clostridium perfringens is a gram-negative spore-bearing bacillus
Gas gangrene is characterized by severe local pain, crepitus and signs of toxemia
High dose penicillin and aggressive debridement of affected tissue is the treatment of established infection
Ans is 'b' i.e. clostridium perfringens is a gram negative spore bearing bacillus Clostridium perfringens is gram positive , spore bearing, obligate anaerobe. Features of gas gangrene (clostridial myonecrosis) Causative agents - Clostridium perfringens Clostridium novyi - Clostridium septicum - Clostridium histolyticum Signs and symptoms - Gas gangrene begins with the sudden onset of pain (feature differentiating if from cellulitis) - Tachycardia but no elevation in temperature - Gas is not seen in early stage Skin is tense, white often marbled with blue. It is cooler than normal. - The symptoms progress rapidly; swelling edema, and toxemia increase, and a profuse serous discharge, which may have a peculiar sweetish smell, appears. Appearance of gas produces body crepitations Management: ? - Surgical debridement (fasciotomy is done immediately) - Antibiotics --) penicillin + clindamycin - Polyvalent gas gangrene antitoxin (controversial) - Hyperbaric oxygen therapy (controversial)