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J Lab Physicians 2019 Jan-Mar;11(1):94-96

Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.

Gas gangrene is a necrotic infection of the skin and soft tissue that is associated with high mortality and often necessitating amputation to control the infection. Clostridial myonecrosis is most often cause of gas gangrene and usually present in settings of trauma, surgery, malignancy, and other underlying immunocompromised conditions. The most common causative organism of clostridial myonecrosis is followed by . Read More

Anaerobe 2019 Apr 4;57:90-92. Epub 2019 Apr 4.

Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan. Electronic address:

We report the case of a patient with advanced gastric cancer and multiple liver metastases, who presented with bacteremia and hepatic gas gangrene caused by Clostridium novyi (C. novyi). The gas gangrene caused abscesses to form within metastatic lesions. Read More

Gene 2019 Mar 22;701:152-160. Epub 2019 Mar 22.

Biotechnology Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata-700120, West Bengal, India.

Edwardsiella tarda belongs to the genera of Gram negative bacterium mainly associated with edwardsiellosis, the most commonly found infectious fish disease throughout the globe. E. tarda is also a widespread pathogen which cause infections such as cellulitis or gas gangrene and generalized infections in humans. Read More

J Glob Antimicrob Resist 2019 Mar 5;17:23-24. Epub 2019 Mar 5.

College of Pharmaceutical Sciences, Nanjing Tech University, Nanjing 210009, People's Republic of China.

Objectives: Bacillus cereus is associated with a variety of human diseases such as haematological malignancies, tetanus, gas gangrene, food poisoning and pseudomembranous colitis. Our team found and isolated a strain, named B. cereus S66, from radiation-contaminated soil in Xinjiang Uygur Autonomous Region. Read More

BMC Vet Res 2018 Dec 18;14(1):406. Epub 2018 Dec 18.

Department of Microbiology, Faculty of Veterinary Medicine, University of Firat, 23119, Elazig, Turkey.

Background: Even though gas gangrene caused by Clostridium septicum in goats is mentioned in the classical textbooks, we have not managed to find any case description in the literature.

Case Presentation: Clinical signs resembling gas gangrene such as subcutaneous bloating, edema and crepitation were detected at various body parts of nine pregnant animals at the ages of 2-3 years on a hair goat farm (n = 170) located in Bingol province, Eastern Turkey. Five of these suspected animals with severe clinical symptoms died within 2 days. Read More

Singapore Med J 2018 Nov;59(11):611-613

Department of Cardiology, National University Heart Centre, Singapore.

Oral Radiol 2018 Jan 20;34(1):83-87. Epub 2017 Mar 20.

Department of Oral Radiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan.

Cellulitis accompanied by gas gangrene is a rapidly-spreading and potentially fatal infection. Here, we present a case of gas gangrene in the deep spaces of the head and neck in an elderly woman, diagnosed by computed tomography (CT). An 86-year-old woman with Alzheimer's disease, hypertension, hyperlipidemia, and osteoporosis was referred to our institute by her local dentist. Read More

Acta Vet Scand 2018 Oct 11;60(1):61. Epub 2018 Oct 11.

Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, 1350, Copenhagen K, Denmark.

Background: Vultures have adapted the remarkable ability to feed on carcasses that may contain microorganisms that would be pathogenic to most other animals. The holobiont concept suggests that the genetic basis of such adaptation may not only lie within their genomes, but additionally in their associated microbes. To explore this, we generated shotgun DNA sequencing datasets of the facial skin and large intestine microbiomes of the black vulture (Coragyps atratus) and the turkey vulture (Cathartes aura). Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):369-376

* Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Purulent musculoskeletal infections often require surgical debridement and drainage. However, when the infection is extensive or involving multiple layers of tissues, maintaining drainage of the involved spaces can be difficult, even with the application of vacuum-assisted closure (VAC) therapy. Wide exposure and aggressive debridement is often required for such cases, which in turn may complicate wound coverage. Read More

Yakugaku Zasshi 2018 ;138(10):1249-1253

Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University.

　Whereas granulopoiesis during Gram-negative bacterial infection is accelerated through activation of toll-like receptor 4 (TLR4), it has not been elucidated whether Gram-positive bacterial infection can stimulate granulopoiesis. Using the well-known TLR2 agonist peptidoglycan (PGN), it was shown that neutrophils in bone marrow and spleen and plasma granulocyte colony-stimulating factor were increased in mice that had received intraperitoneal administration of PGN. Incorporation of bromodeoxyuridine into bone marrow neutrophils increased in mice administered PGN, demonstrating that PGN promotes granulopoiesis. Read More

Surg Clin North Am 2018 Oct 29;98(5):1097-1108. Epub 2018 Jul 29.

Department of Surgery, Division of Trauma and Acute Care Surgery, East Carolina University, Brody School of Medicine, 600 Moye Boulevard, Greenville, NC 27858, USA.

Necrotizing soft tissue infections (NSTI) are characterized by rapidly progressive infection that causes tissue necrosis with associated sepsis and multisystem organ failure. A rapid diagnosis is essential to decreasing the morbidity and mortality of NSTIs. There must be a high index of suspicion based on history and physical examination. Read More

Scott Med J 2018 Aug 28:36933018793525. Epub 2018 Aug 28.

3 Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, Golden Jubilee National Hospital, UK.

Introduction The Clostridia species are responsible for life-threatening conditions such as tetanus, botulism and gas gangrene. Clostridium septicum is a rare cause of clinical infection, accounting for less than 1% of blood culture samples that test positive for Clostridia. However, C. Read More

BMC Musculoskelet Disord 2018 Jul 25;19(1):254. Epub 2018 Jul 25.

Department of Orthopedics, West China Hospital, Sichuan University, 37# Guoxue Alley, Chengdu, 610041, People's Republic of China.

Background: Gas gangrene is an invasive, fatal anaerobic infection that is characterized by acute, rapid evolution and high mortality. Gas gangrene is often secondary to open fractures with deep wounds but is extremely rare in the patients undergoing elective surgery. Implant removal is a common elective operation in orthopedics after the union of fractures, and the complications of this surgery include infection, nerve injury and re-fracture. Read More

Ned Tijdschr Geneeskd 2018 Jun 22;162. Epub 2018 Jun 22.

Ziekenhuis Gelderse Vallei, afd. Intensive Care, Ede.

An immunocompromised 78-year-old woman had a painful hip and subacute fever. An abdominal CT scan revealed a diverticular sigmoid stenosis fistulating to the presacral space, with free gas in the paravertebral musculature and spinal canal. Because a deep necrotising infection was suspected, she underwent surgery and was treated with antibiotics. Read More

Int J Antimicrob Agents 2018 Oct 14;52(4):469-473. Epub 2018 Sep 14.

Department of Veterans Affairs Medical Center, Boise, ID, USA; University of Washington School of Medicine, Seattle, WA, USA.

Clostridium septicum is a highly pathogenic microbe that causes gas gangrene in humans, and is the principal cause of spontaneous gas gangrene in patients with gastrointestinal maladies, including adenocarcinoma of the colon. Despite modern approaches to manage C. septicum infection, morbidity and mortality remain high (>60%). Read More

FEMS Microbiol Lett 2018 Aug;365(16)

Animal Biosciences and Biotechnology Laboratory, Agricultural Research Service, BARC, USDA, 10300 Baltimore Ave., Beltsville, MD, USA.

Clostridium perfringens, a spore-forming anaerobic bacterium, causes food poisoning and gas gangrene in humans and is an agent of necrotizing enteritis in poultry, swine and cattle. Endolysins are peptidoglycan hydrolases from bacteriophage that degrade the bacterial host cell wall causing lysis and thus harbor antimicrobial therapy potential. The genes for the PlyCP10 and PlyCP41 endolysins were found in prophage regions of the genomes from C. Read More

Int J Surg Case Rep 2018 30;49:121-125. Epub 2018 Jun 30.

Department of Surgery, Shonan Kamakura General Hospital, Japan.

Introduction: Liver gas gangrene is rare and has a low prognosis. This case, reports a successful treatment of hepatic gas gangrene using an open drainage technique, followed by antibiotics and hyperbaric oxygen therapy (HBO).

Presentation Of The Case: An 82-year-old male with a history of left hepatectomy and bile duct resection for hilar cholangiocarcinoma presented with chilling, lethargy and dyspnea. Read More

Ann Clin Microbiol Antimicrob 2018 Jul 9;17(1):31. Epub 2018 Jul 9.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Streptococcus pyogenes is an uncommon pathogen of purpura fulminans, and the pathogenesis of S. pyogenes-purpura fulminans remains unclear because of paucity of cases. We reported a pediatric case of S. Read More

Urol Case Rep 2018 Sep 26;20:7-8. Epub 2018 May 26.

Department of Urology, La Rabta University Hospital, Tunisia.

BMC Pediatr 2018 06 22;18(1):198. Epub 2018 Jun 22.

Department of Stomatology, Children's Hospital, Zhejiang University School of Medicine, NO.3333 Binsheng Road, Hangzhou, 310052, Zhejiang Province, People's Republic of China.

Background: Hemolytic streptococcus gangrene is a life threatening invasive bacterial infection. Hemolytic streptococcus gangrene in the danger triangle of the face is too lethal to operate. A case of the confirmed hemolytic streptococcus gangrene in the danger triangle of the face caused by Group A beta-hemolytic streptococcus (GAS) in 20-months old boy is presented to draw attention of clinicians to this uncommon but frequently fatal infection. Read More

Diabetes Metab Syndr Obes 2018 1;11:255-264. Epub 2018 Jun 1.

Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Diabetes is associated with various complications and reduced quality of life. Of the many complications, some are life-threatening. Among these, foot complications remain an important concern. Read More

Dermatol Online J 2018 Apr 15;24(4). Epub 2018 Apr 15.

Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Many cases of superinfected hidradenitis suppurativa (HS) involve multiple species of bacteria, but gas-producing infections are rare and can complicate the clinical picture. Additionally, recognizing squamous cell carcinoma (SCC) as a complication of longstanding HS is imperative. Herein, we present a unique case of a severe emphysematous HS that was initially mistaken for Fournier gangrene and eventually diagnosed as superinfected SCC. Read More

Infection 2018 Oct 29;46(5):711-716. Epub 2018 May 29.

Department of Surgery, Amphia Ziekenhuis, Molengracht 21, 4818 CK, Breda, The Netherlands.

A mycotic aneurysm caused by a Clostridium septicum is a rare infection and has a strong association with colorectal cancer. If left untreated, the mortality rate of the first 24 h is high. This case report discusses the optimal treatment of emergency surgery combined with antibiotic treatment to improve survival. Read More

BMC Genomics 2018 May 22;19(1):379. Epub 2018 May 22.

Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, VIC, 3800, Australia.

Background: Clostridium perfringens causes a range of diseases in animals and humans including necrotic enteritis in chickens and food poisoning and gas gangrene in humans. Necrotic enteritis is of concern in commercial chicken production due to the cost of the implementation of infection control measures and to productivity losses. This study has focused on the genomic analysis of a range of chicken-derived C. Read More

Toxins (Basel) 2018 05 22;10(5). Epub 2018 May 22.

California Animal Health and Food Safety Laboratory, San Bernardino Branch, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA 92408, USA.

uses its large arsenal of protein toxins to produce histotoxic, neurologic and intestinal infections in humans and animals. The major toxins involved in diseases are alpha (CPA), beta (CPB), epsilon (ETX), iota (ITX), enterotoxin (CPE), and necrotic B-like (NetB) toxins. CPA is the main virulence factor involved in gas gangrene in humans, whereas its role in animal diseases is limited and controversial. Read More

Med Gas Res 2018 Jan-Mar;8(1):29-33. Epub 2018 Apr 18.

Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.

Hyperbaric oxygen therapy (HBOT) is a medical technique which delivers oxygen at ambient pressures to increase the amount of dissolved oxygen in the blood and oxygen distribution to tissues. There are several beneficial properties of HBOT concomitant with elevated oxygen distribution in tissue including anti-inflammation, angiogenesis through vascular endothelial growth factor proliferation, augmented fibroblast activity through fibroblast growth factor proliferation, tissue and wound repair, enhancement of lymphocyte and macrophage activity, increased male testosterone secretion, and bactericidal activity. Given its renown in treating conditions such as decompression sickness and carbon monoxide poisoning, HBOT is making gradual strides for use in genitourinary medicine due to its low risk and likeliness to achieve favorable results. Read More

Wounds 2018 Apr;30(4):90-95

Osiris Therapeutics, Inc, Columbia, MD.

Introduction: Gas gangrene is a rapidly progressive bacterial infection leading to necrosis that usually develops as a result of trauma or postoperative complications. This condition requires early diagnosis with immediate surgical intervention. With a poor prognosis, a high incidence of amputation, and comorbidities such as diabetes and peripheral vascular disease, patients with gas gangrene are put at further risk for surgical complications. Read More

J Emerg Med 2018 06 20;54(6):e133-e135. Epub 2018 Apr 20.

Emergency Medicine Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand.

Hong Kong Med J 2018 04;24(2):191-199

Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.

Hyperbaric oxygen therapy is widely accepted as life-saving treatment for decompression illness. Yet its use in acute carbon monoxide poisoning has remained controversial because of inconsistent findings in clinical trials. Hyperbaric oxygen therapy has an adjunctive role in managing gas gangrene, necrotising soft-tissue infection, and crush injury, as supported by case series. Read More

Microb Pathog 2018 Jun 11;119:200-207. Epub 2018 Apr 11.

Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1 Miki, Kagawa, 761-0793, Japan. Electronic address:

Clostridium perfringens possesses the ethanolamine (EA) utilization (eut) system encoded within the eut operon, which utilizes the EA as a carbon, nitrogen and energy source. To determine the role of the eut system in C. perfringens growth, an in-frame deletion of the eutABC genes was made in strain HN13 to generate the eutABC-deleted mutant strain HY1701. Read More

MBio 2018 03 27;9(2). Epub 2018 Mar 27.

Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Australia

To obtain an insight into host-pathogen interactions in clostridial myonecrosis, we carried out comparative transcriptome analysis of both the bacterium and the host in a murine infection model, which is the first time that such an investigation has been conducted. Analysis of the host transcriptome from infected muscle tissues indicated that many genes were upregulated compared to the results seen with mock-infected mice. These genes were enriched for host defense pathways, including Toll-like receptor (TLR) and Nod-like receptor (NLR) signaling components. Read More

J Foot Ankle Surg 2018 Jul - Aug;57(4):785-789. Epub 2018 Mar 21.

Student, Temple University School of Podiatric Medicine, Philadelphia, PA.

The presence of gas within soft tissues as suggested by plain film radiographs and magnetic resonance imaging is usually sufficient evidence for a gas-producing bacterial infection. A thorough clinical examination and history and tissue culture are necessary to better determine the source of the gas. However, despite the unremarkable physical examination findings, the present case of a plantar puncture wound rapidly developed gas in the tissues and warranted surgical exploration and repair. Read More

J Emerg Med 2018 06 10;54(6):e121-e123. Epub 2018 Mar 10.

Division of Community Internal Medicine, Mayo Clinic, Jacksonville, Florida.

Background: Necrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal cancer or immunocompromise, or both.

Case Report: We report a case of catastrophic atraumatic Clostridium septicum infection in an immunocompromised host. Read More

Int J Antimicrob Agents 2018 Jul 6;52(1):1-10. Epub 2018 Mar 6.

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.

Microsurgery 2019 Feb 16;39(2):174-177. Epub 2018 Feb 16.

Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany.

Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. Read More

Med J Aust 2018 02;208(2):64

Save Sight Institute, Sydney, NSW.

J Biosci Bioeng 2018 May 17;125(5):525-531. Epub 2018 Jan 17.

Laboratory of Microbial Technology, Faculty of Agriculture, Graduate School, Kyushu University, Fukuoka 812-8581, Japan. Electronic address:

Clostridium perfringens produces various exotoxins and enzymes that cause food poisoning and gas gangrene. The genes involved in virulence are regulated by the agr-like quorum sensing (QS) system, which consists of a QS signal synthesis system and a VirSR two-component regulatory system (VirSR TCS) which is a global regulatory system composed of signal sensor kinase (VirS) and response regulator (VirR). We found that the perfringolysin O gene (pfoA) was transiently expressed during mid-log phase of bacterial growth; its expression was rapidly shut down thereafter, suggesting the existence of a self-quorum quenching (sQQ) system. Read More

BMJ Case Rep 2018 Jan 4;2018. Epub 2018 Jan 4.

Emergency and General Internal Medicine, Hitachinaka General Hospital, Hitachinaka, Japan.

Am J Emerg Med 2018 Mar 6;36(3):526.e1-526.e3. Epub 2017 Dec 6.

Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Taiwan. Electronic address:

The incidence of colon ischemia has increased in recent years, and is associated with high morbidity and mortality. The typical presentations of colon ischemia include abdominal pain, bloody diarrhea, and in severe case, ileus, fever and peritonitis. Here, we document a rare case of colon ischemia presenting with subcutaneous and intramuscular emphysema of the thigh. Read More

Curr Opin Infect Dis 2018 04;31(2):113-119

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.

Purpose Of Review: To review the salient features of the management of severe skin and soft tissue infections (SSTIs), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis.

Recent Findings: For severe SSTIs, intensive care, source control, and broad-spectrum antimicrobials are required for the initial phase of illness. There is an increasing focus on the utility of rapid diagnostic tests to help in selection and de-escalation of antimicrobials for SSTIs. Read More

Anaerobe 2018 Feb 12;49:48-52. Epub 2017 Dec 12.

Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil. Electronic address:

Clostridium perfringens alpha toxin, encoded by plc gene, has been implicated in gas gangrene, a life threatening infection. Vaccination is considered one of the best solutions against Clostridium infections. Although studies have identified many low quality clostridial vaccines, the use of recombinant proteins has been considered a promising alternative. Read More

Toxicon 2018 Jan 12;141:112-117. Epub 2017 Dec 12.

Department of Pharmacology, Kagawa University Hospital, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan. Electronic address:

Cases of Clostridium perfringens septicemia, such as liver abscess, often develop a rapidly progressive intravascular hemolysis and coagulation; the mortality rate with current standard care including antibiotics and surgery is high. Herein, we firstly investigated the effects of gas gangrene antitoxin (GGA) (antitoxin against C. perfringens) and recombinant human soluble thrombomodulin (rTM) on the hemolysis, coagulation status, inflammatory process, and mortality in α-toxin-treated rats. Read More

Clin Nucl Med 2018 Feb;43(2):112-113

From the Division of Nuclear Medicine, Department of Radiology, McGill University, Montréal, Québec, Canada.

A 66-year-old man with poorly controlled type 2 diabetes was admitted for acute bilateral calf pain in the context of coronary artery disease, chronic renal failure, and peripheral neuropathy. Lower-extremity Doppler ultrasound excluded deep vein thrombosis. FDG-PET was performed to exclude a suspected infection because of elevated white blood cells and inflammatory markers but normal creatinine kinase levels. Read More

N Engl J Med 2017 Dec;377(23):2253-2265

From the Veterans Affairs Medical Center, Boise, ID; and the University of Washington School of Medicine, Seattle.

Gut Pathog 2017 21;9:69. Epub 2017 Nov 21.

Animal Biosciences and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service-US Department of Agriculture, Beltsville, 10300 Baltimore Avenue, MD 20705 USA.

Background: is ubiquitous in nature. It is a normal inhabitant in the intestinal tract of animals and humans. As the primary etiological agent of gas gangrene, necrosis and bacteremia, causes food poisoning, necrotic enteritis (NE), and even death. Read More

BMJ Case Rep 2017 Dec 2;2017. Epub 2017 Dec 2.

General Surgery, University Hospital Limerick, Limerick, Ireland.

Gas gangrene is a life-threatening, necrotising soft tissue infection. Colorectal malignancy-associated is a rare cause of gas gangrene. This case outlines an initial presentation of colonic malignancy as gas gangrene from infection. Read More

Microorganisms 2017 11 24;5(4). Epub 2017 Nov 24.

Department of Plant and Microbial Biology, University of California, Berkeley, CA 94720, USA

While the microbial degradation of a chloroxyanion-based herbicide was first observed nearly ninety years ago, only recently have researchers elucidated the underlying mechanisms of perchlorate and chlorate [collectively, (per)chlorate] respiration. Although the obvious application of these metabolisms lies in the bioremediation and attenuation of (per)chlorate in contaminated environments, a diversity of alternative and innovative biotechnological applications has been proposed based on the unique metabolic abilities of dissimilatory (per)chlorate-reducing bacteria (DPRB). This is fueled in part by the unique ability of these organisms to generate molecular oxygen as a transient intermediate of the central pathway of (per)chlorate respiration. Read More

J Surg Res 2017 12 1;220:372-378. Epub 2017 Sep 1.

Department of Surgery Division of Trauma and Acute Care Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Background: Whether patients with necrotizing soft tissue infections (NSTI) who presented to under-resourced hospitals are best served by immediate debridement or expedited transfer is unknown. We examined whether interhospital transfer status impacts outcomes of patients requiring emergency debridement for NSTI.

Methods And Materials: We conducted a retrospective review studying patients with an operative diagnosis of necrotizing fasciitis, Fournier's gangrene, or gas gangrene in the 2010-2015 American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files. Read More