Uncommon Infections

Gas gangrene This is usually a complication of deep dirty wounds (especially in battlefields). Gas can be seen on soft tissue X-rays. A variety of bacteria can cause it but the most severe is Clostridia. Mixed infection is not uncommon. It presents in deep wounds involving muscle. Swelling and oedema occur around a discharging wound. Severe toxaemia may be present but the patient is often afebrile. Mottling and subsequent black necrosis of wound occurs. Crepitation may be felt. Diagnosis is based on the clinical findings, wound swabs, and X-rays. Treatment - IV penicillin and metronidazole. Clostridia needs extensive surgical debridement.