Gas gangrene diagnosed from culture of tissue

A 65-year-old man with type 2 diabetes of 23 years' duration and chronic ischaemia developed four necrotic toes following an episode of infection which was treated in hospital with intravenous antibiotics. Vascular intervention was not feasible and the toes were treated conservatively, with treatment consisting of pain control with liberal analgesia, oedema control with diuretics, infection control with oral antibiotics, and wound control with

Fig. 6.17 (a) The proximal portion of this necrotic ulcer was wet and discharging pus. (b) The same ulcer 2 weeks later after debridement of wet necrosis, (c) 10 weeks after the first debridement the toe is healing well.

Fig. 6.17 (a) The proximal portion of this necrotic ulcer was wet and discharging pus. (b) The same ulcer 2 weeks later after debridement of wet necrosis, (c) 10 weeks after the first debridement the toe is healing well.

Clostridium Perfringens Gangrene
Fig. 6.18 Clostridium perfringens. A tissue sample was sent for culture from the necrotic area at the base of the 3rd toe.

regular debridement along the demarcation line between necrosis and viable tissue.

After 8 weeks (Fig. 6.18), a tissue sample was sent for culture and grew Clostridium perfringens from tissue and not from the swab. We recalled the patient to clinic: he had an X-ray which revealed gas in the tissues. He was admitted, underwent surgical debridement and was given benzylpenicillin 1.2 g qds intravenously. He was discharged after 1 week. Over the next 8 months the gangrene auto-amputated and the foot healed.

Key points

• Diabetic patients with necrosis in the foot require close follow-up in the diabetic foot clinic and intense surveillance to detect infection

• Without regular microbiological investigations this serious infection would not have been diagnosed early

• Clostridium perfringens is best treated by high-dose intravenous penicillin.

Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook


Responses

  • jonatan
    How to diagonosed gas gangrene in foot?
    7 years ago

Post a comment