Clostridial myonecrosis

Another important necrotizing skin and soft tissue infection is clostridial myonecrosis (gas gangrene). Clostridial myonecrosis can develop spontaneously but most often occurs after trauma. Clostridium perfringens is the most common causative pathogen. 

Tens of thousands of Americans, including 1 of every 12 persons with spinal cord injury, die each year as a result of complications relating to pressure sores.41 Most complications are infectious. The most common is osteomyelitis, which is present in approximately 38% of infected pressure sores.37 Less frequently, NF, clostridial myonecrosis, and sepsis can occur. 

Clostridial gas gangrene (myonecrosis) should be treated with clindamycin and penicillin. 

In some instances, epinephrine can be a cause of a blood condition involving the leukocytes and known as neutrophilia. In very rare cases, an intramuscular injection of epinephrine can be a cause of clostridial myonecrosis (gas gangrene). 

C. perfringens is the most important of the histotoxic clostridia that cause tissue infections in humans, especially of the muscle tissue (clostridial myonecrosis or gas gangrene). The organism is more aerotolerant than most other anerobes. In addition to toxins and enzymes, many of which have lethal, cell-destroying and hemolytic properties, a number of nonlethal enzymes are also produced and apparently contribute to the invasiveness of the organism in the tissue. These include collagenase, deoxyribonuclease, and hyaluronidase. 

Clostridial myonecrosis is a necrotizing infection that involves the skeletal muscle. Gas production and muscle necrosis are prominent features of this infection, which readily explains why this infection is commonly referred to as gas gangrene. ° The infection advances rapidly, often over a matter of a few hours." Most infections occur after surgery or trauma, with Clostridium perfringens identified as the most common etiologic agent. 

Unlike necrotizing fasciitis, clostridial myonecrosis shows little inflammation on histologic examination. 

D.J. Bakker, Clostridial myonecrosis, in "Problem Wounds The Role of Oxygen," J.C. Davis,... 

Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis. Surgery. 77 75(1975),... 

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