Gas gangrene (gas edema; ICD-10-GM A 48.0: Gas gangrene [gas edema]) describes an infection with clostridia of the gas gangrene group. In the majority of cases, the infection is due to wound contamination with the bacterium Clostridium perfringens.
The gas gangrene group includes:
- Clostridium histolyticum
- Clostridium novyi
- Clostridium perfringens type A – responsible for 60-80% of cases.
- Clostridium septicum
Clostridia are toxin- and spore-forming bacteria that are obligate anaerobes (organisms that do not require free oxygen to live). The toxins cause the tissue at the infected site to die. Gas also forms in the tissue.
Occurrence: The pathogens occur worldwide. They are found primarily in soil, but also in dust and water. Clostridia are part of the natural intestinal flora and the female genital flora.
The spores of the bacterium are very resistant to heat and desiccation.
One can distinguish exogenous from endogenous infections. Exogenous infections arise from contamination of wounds (e.g. in the course of accidental injuries), endogenous infections usually originate from the intestine and occur in severe malignant (malignant) diseases such as tumor diseases (cancer).
The incubation period (time from infection to onset of disease) in exogenous infection is usually a few hours to 5 days.
Sex ratio: males to females is 2-3: 1.
Peak incidence: endogenous infection (enteritis necroticans) occurs predominantly in childhood. The exogenous infection (gas gangrene) often occurs in individuals between the ages of 35 and 40.
In Germany, the disease occurs only rarely.
Course and prognosis: Gas gangrene is a severe, life-threatening disease. It is accompanied by sudden onset of wound pain, the intensity of which increases. The course can be fulminant and lead to death within a few hours.
The lethality (mortality in relation to the total number of people suffering from the disease) is up to 50%, even with adequate therapy.
In Germany, the disease is not reportable according to the Infection Protection Act (IfSG).
