Clostridium Perfringens: A Flesh-Eating Bacterium Living in Your Garden (Clinical Feature) (Report‪)‬

Gas gangrene evokes pictures of trench warfare in the First World War with thousands of soldiers dying in terrible pain. It has nothing to do with the mustard gas that was used in warfare, but is rather caused by the bacterium Clostridium perfringens; infected tissue dies quickly giving the appearance of the flesh having been eaten almost in front of one's eyes. After surgical debridement of the wound, Dr Alexis Carrel devised a method of swab tests for bacteria causing gas gangrene and scientific methods for calculating the number of the bacteria in the wound so that the wound could be closed at the appropriate time. A successful method of irrigating infected wounds was devised using Dakin's solution, but this has been superseded by the use of antibiotics. Today, cases do occur in the civilian population. The onset of infection can be rapid requiring immediate surgical debridement in sterile conditions, antibiotic treatment and closure of the wound only when free from bacteria. Once observed, gas gangrene is not easily forgotten. Gas gangrene is the name given to a type of infection caused by six species of Clostridium, with Clostridium perfringens accounting for most cases (Revis 2008). Clostridia are spore-forming bacilli with anaerobic Gram-positive properties, often found in soil although they are also part of the normal flora of the gastrointestinal tract, biliary tract and female genitourinary tracts, and found in colonies on the skin (Minutti & Immergluck 1999). Gas gangrene is an intensively aggressive, highly lethal infection that affects the muscles. After germination of spores in the muscle, bacterial multiplication and toxin production occur. Cl. perfringens can produce at least 20 exotoxins, with alpha-toxin being the most virulent, causing cell destruction by hydrolysis of key cell membrane components and lysis of erythrocytes, leukocytes, platelets, fibroplasts and muscle cells. As a result other systems may be affected with hypotension, renal failure, coma and death (Revis 2008).