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Surgery General 365e5cc4

Which of the following is not true of gas gangrene?

A
It is caused by clostridium perfringens
B
Clostridium perfringens is a gram-negative spore-bearing bacillus
C
Gas gangrene is characterized by severe local pain, crepitus and signs of toxemia
D
High dose penicillin and aggressive debridement of affected tissue is the treatment of established infection
High-Yield Explanation
Ans is 'b' i.e. clostridium perfringens is a gram negative spore bearing bacillus Clostridium perfringens is gram positive , spore bearing, obligate anaerobe. Features of gas gangrene (clostridial myonecrosis) Causative agents - Clostridium perfringens Clostridium novyi - Clostridium septicum - Clostridium histolyticum Signs and symptoms - Gas gangrene begins with the sudden onset of pain (feature differentiating if from cellulitis) - Tachycardia but no elevation in temperature - Gas is not seen in early stage Skin is tense, white often marbled with blue. It is cooler than normal. - The symptoms progress rapidly; swelling edema, and toxemia increase, and a profuse serous discharge, which may have a peculiar sweetish smell, appears. Appearance of gas produces body crepitations Management: ? - Surgical debridement (fasciotomy is done immediately) - Antibiotics --) penicillin + clindamycin - Polyvalent gas gangrene antitoxin (controversial) - Hyperbaric oxygen therapy (controversial)

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