Clostridial Myonecrosis Treatment: Antibiotics, Debridement, and HBOT

Clostridial Myonecrosis is a life-threatening condition and immediate treatment is essential. Initial treatment is immediate intravenous antibiotics and wound debridement. The idea is to remove all the infected or dead tissue and allow healthy tissue to heal. In severe cases, this can mean limb amputation. This is where HBOT treatments, alongside antibiotics and debridement, can make a big difference. By flooding the infected tissue with oxygen, HBOT essentially destroys the oxygen-deprived environment that allows the bacteria to flourish. In this case, hyperbaric oxygen and HBOT are an FDA-approved treatment option for Clostridial Myonecrosis that enhances the survival rate, helps to avoid mutilating surgeries, such as amputations, and allows for maximum tissue preservation.

Amputee with Clostridial Myonecrosis does physical therapy after HBOT Treatment

What is Clostridial Myonecrosis?

Clostridial Myonecrosis is a life-threatening medical emergency where a clostridial infection spreads into the deep muscle tissue. It is broken down into two main forms: Traumatic and Spontaneous. The main cause of the traumatic form is the bacteria Clostridium perfringens, while Clostridium septicum is the cause of the spontaneous form.

Traumatic infections occur when an injury or trauma results in reduced or blocked blood flow to the tissue, such as a crush injury. The bacteria enter the wound, and, in a deprived oxygen environment, spreads quickly. This infection can also happen after a surgical procedure.

Spontaneous infections typically occur in immunocompromised individuals or underlying medical conditions, such as cancer of the colon or rectum, leukemia, and diabetes mellitus. It is believed that with weakened immune systems, the body is not strong enough to fight the Clostridium septicum and it populates in the gut and with no immune system to fight it off, it quickly spreads.

Clostridium is found just about everywhere, but once it enters the body and spreads, it releases gas and toxins that quickly work to kill tissue, cells and blood vessels.

Symptoms of Clostridial Myonecrosis

Symptoms of Clostridial Myonecrosis

Signs and symptoms vary depending on the type and location of the infection. Rapid onset of severe pain is typically the first symptom, though a person can experience fever, fatigue, and dehydration. Patients with the spontaneous form may experience severe muscle pain, a feeling of heaviness, pressure or numbness. They may also experience confusion.  As the infection spreads, the symptoms worsen and include:

  • Gas Gangrene – As the bacteria grows, it produces toxins that release gas into the deep muscle tissue. This gas quickly causes tissue death and necrosis.
  • Skin Changes – When the infection starts in the deep tissue, the surface skin is typically unaffected. As the infection spreads, the skin may become pale, eventually turning red or brown in color. Fluid- or air-filled sacs called bullae may form on the skin. Eventually, the skin will turn black or dark green, be tender to the touch, and may produce a crackling sound when touched.
  • Foul-smelling Discharge and Edema
  • Aortitis – This happens when the infection spreads to the aorta. The artery may bulge or swell and can result in an aortic rupture.
  • Sepsis – Sepsis is an infection in the blood and can lead to symptoms such as rapid heartbeat, rapid breathing, low blood pressure and changes in cognitive awareness. As it progresses, it can lead to toxic shock and multiorgan failure.

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