Gas Gangrene

Gas gangrene is the result of a dangerous bacterial infection that destroys your tissues. It causes severe blisters, swelling and skin discoloration. It can happen when bacteria (usually Clostridium) get into a deep wound.

Clostridium bacteria release toxins that destroy blood cells, blood vessels and muscle tissue. The bacteria create gas that makes wounds smell bad when they open. The toxins also cause widespread inflammation.

Gas gangrene can be fatal within hours of symptoms starting. Get medical help right away if you have symptoms.

Gas gangrene is rare in the U.S., thanks to modern methods of cleaning wounds. It’s also called clostridial myonecrosis.

Symptoms of gas gangrene

Gas gangrene causes discoloration, swelling and large blisters on your skin where you have a wound. You might see changes in your skin over just minutes or hours. In or around the wound, you might notice:

• Swelling
• Skin that’s discolored, pale, dark red or purplish
• Large bubbles or blisters that are red, brown, dark green or black
• Air pockets under your skin or in the fluid inside blisters
• Foul-smelling fluid draining from blisters
• A crackling feeling or sound when you touch the blisters
• Pain — this might be severe, even if your wound doesn’t look serious

It can also cause other symptoms, including:

• Fever
• Fast heart rate
• Sweating
• Anxiety
• Yellow skin (jaundice)
• Lightheadedness
• Low blood pressure

Gas gangrene causes

The bacterium Clostridium perfringens (C. perfringens) causes most cases of gas gangrene. Other types of Clostridium can also cause it.

These bacteria live in dirt and in the intestines of people and animals. They can get into your skin through deep wounds. There, they release toxins that destroy your blood cells, blood vessels and muscles. This leaves large areas of dead tissue and inflammation.

The bacteria reproduce best in areas with little oxygen. Destroying your blood cells means that less oxygen gets to your tissues. This makes it easier for them to keep reproducing and creating toxins, spreading the damage very quickly. Breaking down nutrients without oxygen (fermentation) also causes the pockets of gas.

How do you get gas gangrene?

The most common way to get gas gangrene is through a severe injury that goes deep into your body. These wounds are hard to clean completely. They also aren’t exposed to oxygen in the air, which kills C. perfringens bacteria.

An injury is at further risk for gas gangrene if:

• It goes into your muscle.
• It’s contaminated with dirt or debris.
• You can’t clean it out quickly after getting injured.

Examples of these types of injuries include road rash from a car or motorcycle accident, gunshot wounds and stab wounds.

Less common causes of gas gangrene include:

• Colon, gallbladder and other abdominal (belly) surgeries
• Gynecological surgeries or procedures
• Tumors or other conditions that can damage your GI tract
• Childbirth
• Miscarriage
• Complications of diabetes or other conditions that reduce blood flow and oxygen to your tissues

Risk factors

Severe injuries and abdominal surgeries put you at higher risk for traumatic gas gangrene. You’re at higher risk for spontaneous gas gangrene — when an injury doesn’t cause it — if you have certain underlying conditions, including:

• Colon cancer
• Diverticulitis, which can damage your colon
• Diabetes
• Blood vessel disease, like atherosclerosis

Even if you have one of these risk factors, it’s important to remember that it’s still extremely unlikely that you’ll ever have gas gangrene.

Complications

Gas gangrene can quickly lead to life-threatening complications, including:

• Renal failure: Bacteria rapidly destroying your red blood cells can cause your kidneys to fail.
• Sepsis and septic shock: Clostridium bacteria can cause an extreme reaction in your immune system, with inflammation in your entire body. It can cause your blood pressure to drop dramatically (shock) and your organs to fail.

How doctors diagnose gas gangrene

A provider diagnoses gas gangrene based on your symptoms and how any wounds look. They’ll confirm a diagnosis by taking a biopsy of tissue or fluid from the wound.

They’ll send the tissue to a lab, where it’ll be examined under a microscope for the types of bacteria that cause gas gangrene. They may also try to grow (culture) the bacteria.

Your provider might get X-rays, a CT scan or an MRI to look for gas bubbles or changes in your muscle tissue.

How is gas gangrene treated?

You must get treatment for gas gangrene immediately. A healthcare provider will surgically remove as much of the infected tissue as possible and give you high doses of antibiotics. You may need other treatments depending on the severity of your infection. You’ll need to stay in the hospital for monitoring throughout your treatment.

Your provider may treat you with these medications or procedures:

• Debridement: A provider surgically removes dead and damaged tissue or debris from your wound.
• Antibiotics: Providers often use a combination of penicillin and clindamycin to kill the bacteria causing the gas gangrene.
• Hyperbaric oxygen therapy: This can help heal tissues. It can also slow down infection, as oxygen kills Clostridium bacteria.
• Amputation: In some cases, the best way to prevent further damage and life-threatening illness is to remove the infected limb.

When should I see my healthcare provider?

See a healthcare provider if you have an injury that goes deep into your body. They’ll need to clean a deep wound right away and may need to close it with stitches. They may prescribe antibiotics to prevent infection.

Go to the emergency room immediately if you have symptoms of gas gangrene, especially if you’ve recently had a deep injury or surgery. It’s fatal if it isn’t treated quickly.

What can I expect if I have gas gangrene?

Gas gangrene is a life-threatening emergency. You can expect to stay in the hospital while providers treat you. Providers will:

• Regularly treat and clean your wounds
• Give you IV antibiotics
• Monitor you closely for changes in your condition
• Give you additional treatments and procedures depending on your specific case

Can it be cured?

Gas gangrene can be cured if you get treatment quickly. The outlook depends on what caused it and where on your body it’s doing damage. People who have an infection in their arms, legs, hands or feet have a better prognosis (outlook) than those who have it in their belly or chest, or those with spontaneous gas gangrene.

What’s the survival rate?

Without treatment, gas gangrene is almost always fatal (80% to 90% of cases). With treatment, it’s fatal in 10% to 25% of cases.

Can this be prevented?

Healthcare providers take precautions to prevent any infections during surgery and other procedures. This includes the bacterial infections that cause gas gangrene.

Ways for you to reduce your risk of gas gangrene and other bacterial infections include:

• Clean out wounds with soap and water.
• Get medical attention immediately for any deep wounds. This includes wounds you’re unable to clean completely by washing with soap and water.
• Keep an eye on injuries. Let a provider know if you see changes in your skin or experience severe pain.
• Wear protective gear that covers your arms and legs when riding a motorcycle or bicycle.
• Work with a provider to treat underlying conditions that affect your blood vessels or circulation, or that weaken your immune system.

What’s the difference between gas gangrene and necrotizing fasciitis?

Gas gangrene and necrotizing fasciitis have similar symptoms. They both destroy tissue and can be fatal. The main difference between them is in the types of tissue they usually affect.

Necrotizing fasciitis destroys the fat under your skin and the connective tissues that support your body (fascia). Gas gangrene infects and destroys your blood cells, blood vessels and muscle tissue.

Clostridium usually causes gas gangrene, and group A Streptococcus or Staphylococcus aureus usually cause necrotizing fasciitis.

What’s the difference between gangrene and gas gangrene?

Gangrene is a type of tissue death that happens due to limited blood flow or a bacterial infection. Gas gangrene is a specific type of gangrene caused by a bacterial infection in a deep wound.