USMLE (Fach) / Microbiology (Lektion)

Vorderseite Clostridium perfringens
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Gram-⊕, spore-forming, obligate anaerobic rod.- Ubiquitous

- Wounds with compromised blood supply create an anaerobic environment → optimal for the proliferation of C perfringens → necrosis progresses within 24-36 hours. Such wounds include deep, penetrating wounds (eg, gunshot, knife), open fractures, septic surgical wounds.

- Produces α toxin (lecithinase, a phospholipase) that can cause myonecrosis (gas gangrene; presents as soft tissue crepitus) and hemolysis.- Spores can survive in undercooked food; when ingested, bacteria release heat-labile enterotoxin → food poisoning.

Symptoms:- Excruciating muscle pain- Massive edema with bronze → black skin discoloration and overlying bullae- Sweet, foul-smelling, or nonodorous discharge- Crepitus- Systemic symptoms: fever, tachycardia, altered mental status, shock, multi-organ failure

Differential:- Necrotizing enterocolitis: No crepitus, differentiate with culture- Vibrio vulnificus infection: Wound is exposed to seawater; gram-stain to distinguish

Treatment: Debridement and antibiotics (penicillin + clindamycin/tetracycline)

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