eMedicine Specialties > Emergency Medicine > Infectious Diseases

Gas Gangrene: Follow-up

Author: Anil Shukla, MD, Staff Physician, Harvard Affiliated Emergency Medicine Residency, Beth Israel Deaconess Medical Center
Coauthor(s): Carlo L Rosen, MD, Assistant Professor of Medicine, Harvard Medical School; Program Director, Department of Emergency Medicine, Beth Israel Deaconess Medical Center/ Harvard Affiliated Emergency Medicine Residency program; Jason K Wong, MD, Staff Physician, Department of Emergency Medicine, Jefferson Regional Medical Center
Contributor Information and Disclosures

Updated: Jun 22, 2009

Follow-up

Further Inpatient Care

  • Urgent surgical debridement may be indicated for gas gangrene.
  • Admit the patient to an ICU with invasive monitoring as necessary.

Inpatient & Outpatient Medications

  • Inpatient medications for gas gangrene include intravenous antibiotics and analgesics.

Transfer

  • Transfer the patient if appropriate surgical specialist and ICU setting are unavailable.

Deterrence/Prevention

  • Appropriate wound care at time of injury (eg, debridement of crushed or dead tissue, copious irrigation) may deter infection.
  • Prophylactic antibiotics may prevent subsequent infection in selected circumstances.

Complications

  • Gas gangrene may progress rapidly; patients often become septic.

Prognosis

  • Early diagnosis and aggressive treatment of gas gangrene are the keys to decreasing mortality.

Miscellaneous

Medicolegal Pitfalls

  • Gas gangrene and necrotizing myositis in general can present with very subtle signs early in its course. A high index of suspicion is necessary to avoid catastrophes. Once the diagnosis is established, timely intervention with aggressive resuscitation, appropriate antibiotics, and surgical intervention is indicated.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Wende R Reenstra-Buras, MD, PhD, and N Ewen Wang, MD, for the development and writing of this article.The authors and editors of eMedicine gratefully acknowledge the medical review of this article by Joseph U Becker, MD.



More on Gas Gangrene

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Differential Diagnoses & Workup: Gas Gangrene
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Follow-up: Gas Gangrene
Multimedia: Gas Gangrene
References
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References

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Further Reading

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Keywords

gas gangrene , Clostridium perfringens, C perfringens, Clostridium septicum, C septicum, clostridial myonecrosis, tissue infection, clostridial infection of tissues, emphysematous gangrene, gangrenous emphysema, progressive emphysematous necrosis, gas production, sepsis, myonecrosis, necrotizing myositis, muscle swelling, colon cancer, diabetic peripheral vascular disease, chronic immunosuppression

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Contributor Information and Disclosures

Author

Anil Shukla, MD, Staff Physician, Harvard Affiliated Emergency Medicine Residency, Beth Israel Deaconess Medical Center
Disclosure: Nothing to disclose.

Coauthor(s)

Carlo L Rosen, MD, Assistant Professor of Medicine, Harvard Medical School; Program Director, Department of Emergency Medicine, Beth Israel Deaconess Medical Center/ Harvard Affiliated Emergency Medicine Residency program
Carlo L Rosen, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Jason K Wong, MD, Staff Physician, Department of Emergency Medicine, Jefferson Regional Medical Center
Jason K Wong, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Michelle Ervin, MD, Chair, Department of Emergency Medicine, Howard University Hospital
Michelle Ervin, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, National Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Barry J Sheridan, DO, Chief, Department of Emergency Medical Services, Brooke Army Medical Center
Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

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