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Gas Gangrene — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlGas GangreneSCE Infectious Diseases

A 62-year-old man develops Clostridium perfringens gas gangrene of his right leg following an open tibial fracture. He is septic and deteriorating despite IV Benzylpenicillin. What is the most critical intervention?

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Correct answer: E — Emergency surgical debridement (fasciotomy and excision of necrotic tissue, possible amputation)

Clostridial gas gangrene (myonecrosis) is a surgical emergency with mortality >50% if surgery is delayed. Emergency surgical debridement — often requiring extensive excision of necrotic muscle and potentially amputation — is the single most important intervention. Antibiotics (IV Benzylpenicillin plus IV Clindamycin for toxin suppression) are adjunctive but cannot replace surgery. Hyperbaric oxygen may have a role but must never delay surgical intervention. Crepitus on examination and gas in soft tissues on imaging are diagnostic clues.

Reference: NICE NG141 2019 – Skin and soft tissue infections; WHO 2023 – Surgical infections