Nonclostridial gas gangrene. Report of 48 cases and review of the literature
A. N. Bessman and W. Wagner
Gangrenous lesions accompanied by evidence of subcutaneous gas usually are
diagnosed as "clostridial gas gangrene." The occurrence of nonclostridial
gas gangrene has been infrequently reported and is thought to be relatively
rare. Review of 278 admissions of diabetic patients with orthopedic
vascular problems disclosed a 17% (48 patients) incidence of nonclostridial
gas infections and a 3% (one patient) occurrence of clostridial gas
gangrene. Clinical characteristics ranged from severe to benign toxicity.
Appreciation of the causative organisms (usually mixed Gram-negative rod
and enterococcus) of this syndrome is essential, especially in the diabetic
patient, since appropriate antibiotic therapy and surgery can result in a
low mortality (4%) and a high incidence (80%) of ambulatory, independent
patients.
