Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!

For further information, see CMDT Part 33-05: Clostridial Diseases

Key Features

  • A life-threatening muscle infection produced by any one of several clostridia, such as

    • Clostridium perfringens

    • Clostridium ramosum

    • Clostridium bifermentans

    • Clostridium histolyticum

    • Clostridium novyi

  • Trauma and injection drug use are common predisposing conditions

  • Sudden onset of pain and edema in a contaminated wound

  • Prostration and systemic toxicity

  • Presence of gas in infected tissue

Clinical Findings

  • Hypotension and tachycardia

  • Painful, edematous wound with surrounding pale skin

  • Foul-smelling brown, blood-tinged discharge


  • Brown to blood-tinged watery exudate, with skin discoloration of surrounding area

  • Gas in the tissue by palpation or radiograph

  • Gram-positive rods in culture or smear of exudate

  • Toxins produced in devitalized tissues under anaerobic conditions result in

    • Shock

    • Hemolysis

    • Myonecrosis


  • Surgical débridement with radical excision as necessary

  • Penicillin, 2 million units every 3 hours intravenously (other antimicrobials active against anaerobes are also effective)

  • Clindamycin

    • May decrease the production of bacterial toxin

    • Some experts recommend adding clindamycin, 600–900 mg every 8 hours intravenously, to penicillin

  • Anecdotally, hyperbaric oxygen may be beneficial in conjunction with surgery and antimicrobial therapy

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.