A gas gangrene is a bacterial infection of soft tissue that is life threatening. In most cases, the causative agent is Clostridium perfringens, which is why the disease is also called Clostridial myonecrosis.
This type of infection is particularly responsible for the bacteria quickly causing the affected tissue to die off. The bacteria also form gases, so when listening to the wound a special crackle can be heard. This explains the naming "Gasbrand". The infection can spread very quickly and then pass toxins, so poisons of bacteria into the bloodstream. Then in a short time vital organs are endangered.
The gas gangrene is usually triggered by the bacterium Clostridium Perfringens and found in wounds, into which the pathogen has got into it. For example, deep sores, puncture wounds or war injuries can lead to an infection with the germ.
Especially such wounds are affected, get into the little air and are poorly supplied with blood. As a result, diseases, such as atherosclerosis or diabetes mellitus, which can reduce the circulation in the body, risk factors.
The germ itself can be found in many different places, such as in the soil or in the human gut. Thus, a wound can be infected from the outside by the contaminant or from the intestinal tract of man himself reach other parts of the body.
The latter, however, is only the case when a person's immune system is weakened by other diseases. The bacterium can produce various toxins, ie toxins, which can then take life-threatening damage to other organs via the bloodstream.
Above all, it is important that the diagnosis of the gas fire is made very quickly. In just a few hours, the patient may be in a life-threatening situation. Particularly noticeable and characteristic of gangrene is extremely rapid spread, strong swelling of the surrounding tissue and crackling of the skin when the wound is scanned.
By smearing the wound, you can examine under the microscope whether the type of bacteria can be recognized. In addition, one can detect the formation of gas in an X-ray examination in the affected body part.
The frequency of the gas fire is fortunately not very high. In Germany, about 100 cases are reported each year. In the United States there are about 1000 cases of illness. The mortality is however 50%.
However, a much more common occurrence of infection with the gas gangrene pathogens was recorded during World War I. According to estimates far more than 100, 000 German soldiers died of the infection at that time.
First of all, the gas burn is recognized by the characteristic clinical symptoms and then the diagnosis can be confirmed by laboratory and X-ray examinations. Very characteristic of the infection is the gas formation, which takes place by the bacterium.
The affected wound hurts to a very great extent and can secrete a foul odor. The soft tissue around the wound can develop edema, so show a strong swelling with water deposition in the tissue.
The skin is often discolored blue-violet. These are all the symptoms that affect the affected wound and the surrounding tissue. If the bacterium then releases a toxin, which is toxic to humans, it can also lead to symptoms that affect the whole body or other regions.
For example, if the toxin gets into the brain or kidneys, life-threatening changes in the systemic circulation can occur. This can be manifested among other things by shock signs, so a drop in blood pressure and an increase in heart rate ( see also : heart tachycardia).
Ideally, gas gangrene is quickly diagnosed on the basis of typical clinical signs, so that therapy can be started as soon as possible. However, as every minute counts, in many cases the treatment must be carried out on suspicion.
The priority is surgical treatment. For this, the infected, dead tissue is surgically removed. An extensive cleansing is necessary. In some cases, an amputation of the body part must be made. In this way one wants to prevent the further spread of the germ.
At the same time, antibiotic therapy must be used. In many cases, there are also infections with other bacteria, so that several different antibiotics are given.
Supporting the circulation is monitoring the patient in intensive care with adequate hydration. Unfortunately, every second part of the infection dies despite the therapy. The dangerous aspect of the gas burn is that the infection spreads rapidly and can lead to death between hours and days.
The gas fire-causing bacterium can only grow if there is no oxygen. So especially in the soil, in deep wounds and poorly perfused tissues. In a pressure chamber can be reached with excess pressure, a very high oxygen pressure, so that the bacteria die.
Unfortunately, there is often the problem here that the patients are not stable enough to be transported into such a chamber. To make matters worse, pressure chambers are not available everywhere in Germany.
In the majority of cases, gas gangrene is triggered by the bacterium Clostridium perfringens. But other germs can be responsible for this dangerous disease. A vaccine for humans is currently not allowed.
For animals that can also be infected, however, there is a vaccine. In this case, an attenuated form of the toxin that the bacteria give off, is added via the syringe into the body of the animal. Thus, the immune system can recognize the toxin and be trained to fend off the invading substances.
Fortunately, the incidence of the disease is extremely rare, so a vaccine may not be appropriate.
Unfortunately, the forecast of the gas fire is very bad. Without surgical therapy it is said that the mortality rate is 100%. This means that all patients who become infected with a gas gangrene and do not receive timely medical treatment die.
Due to the surgical therapy, ie the generous removal of the affected tissue, a purge or even an amputation, the probability of death from the infection can be reduced to 50%. Within a few hours to days, the infection can lead to death.
The gas fire is especially dangerous, especially since the course of the disease itself is so fast. If the pathogen gets into a person's wound, the disease can break out after just a few hours.
The patient then complains of severe pain and the typical symptoms of the disease, such as the crackle of palpation and a foul odor. After just a few hours, a toxin released from the germ can then enter other organs of the body and put the patient in mortal danger.
Because of these small windows, there is little room for speculation and investigation. In this particular case, the attending physician must act quickly on the basis of the typical clinical symptoms and carry out the therapy radically.
Whether the gas gangrene is contagious in the sense of a transfer from one person to another is unknown and unlikely. The most common causative agent of gas gangrene is also found in the intestinal tract of the human or in the genital tract. So it can happen that in an already weakened immune system, the germ can be moved to other parts of the body and there triggers an infection.
On the other hand, the bacterium, which is also often in the ground, colonize a wound from the outside. In the First World War, the spread of the gas fire was a bad event favored by soiled medical tools.