Thanks!

Thank you for checking out our blog.  We enjoyed learning about different factors that cause different types of gangrene and maybe even enjoyed looking at the pictures.  We hope you enjoy as well!

Shaun and Alex

Wet Gangrene

Wet gangrene is the type of gangrene that you see in pictures that makes your stomach turn.  There are many factors that can influence the development of wet gangrene.  Some of these include diabetes, frostbite, cuts and atherosclerosis.  It is often the case that someone with poor circulation suffers an injury to an area and may not really notice it.  This would be the case with someone who is diabetic.  Atherosclerosis is damage to blood vessel disease which can cause tissue death in surrounding areas.  Often times this leads to what is called dry gangrene, but if a bacterial infection becomes present, wet gangrene may be the result.  This is similar to the way that frostbite may cause gangrene to develop.  Two bacterias are the prime suspects of wet gangrene and these are Staphylococcus and Streptococcus groups.  We know about these bacterias and how they work from lecture.

Treatment of wet gangrene is basically the same type of treatment as the treatment for gas gangrene, usually involving antibiotics and surgical removal of necrotized flesh and amputation when necessary.

So, be careful if you experience frostbite, cuts in numb extremities or injuries that crush and cut off blood supply because these types of injuries are the ones most likely to lead to wet gangrene.

References:

http://www.humanillnesses.com/Infectious-Diseases-Co-Ha/Gangrene.html

http://www.mayoclinic.com/health/gangrene/ds00993/dsection=causes

Future Prospects

In recent years (since 2000), the number of cases of gangrene has been on the rise. Because gangrene often begins with insufficient blood supply to limbs, those with conditions that obstruct blood vessels (such as diabetes), are at a heightened risk for the disease. Taking into account America’s increasing problem with obesity, a risk factor for diabetes, incidences of gangrene may only become more common.

Being aware that the most common risk factors for (dry) gangrene include cardiovascular disease, obesity, and cigarette smoking, you may want to think twice next time you decide to supersize that meal at your favorite fast food joint or take a drag off your cig. By no means will making these choices alone give you gangrene, but it’s important to realize that you have the ability to reduce your risk.

Note: Although dry gangrene is not technically an infection, it has the potential to become infected and progress to wet gangrene, which is a more serious variant of the disease.

References:

http://diabetes.about.com/od/glossaryofterms/g/gangrene.htm

Why You Don’t Want Gangrene!

Gangrene most commonly affects the extremities (hands, fingers, feet, toes), but can be found in other areas as well, such as the lungs, intestines, and genitals (Fournier’s gangrene).

Dry Gangrene:

Wet Gangrene:

Gas Gangrene:

Gas Gangrene

One of the types of bacterial gangrene is gas gangrene, where an estimated 1000-3000 cases occur annually in the U.S.  This type of gangrene is typically the result of a recent surgical wound or trauma to an area.  This infection is typically caused by the bacteria Clostridium perfringens, which is a Gram +, rod shaped, spore forming bacteria.  Symptoms as listed on the medlineplus.gov website include:

• Air under the skin
  
• Blisters filled with brown-red fluid
• Drainage from the tissues, foul-smelling brown-red or bloody fluid
• Increased heart rate
• Moderate to high fever
• Moderate to severe pain around a skin injury
• Pale skin color, later becoming dusky and changing to dark red or purple
• Progressive swelling around a skin injury
• Sweating
• Vesicle formation, combining into large blisters
• Yellow color to the skin

A typical symptom from this type of wound is a crackling noise when pressure is applied to the wound.  This is the gas below the skin and is why this is called gas gangrene.  One interesting thing to note is that onset of this type of infection is usually sudden and dramatic.  So, if you see any of these symptoms pop up after a surgery or other form of tissue damage, it is vital to seek help immediately to avoid your tissue being eaten away by the infection.

Treatment may involve intravenous antibiotics of the penicillin type with clindamycin.  Other necessary steps in treatment are surgical debridement, or removal, of infected tissue.  Because this infection is a rapidly spreading one, amputation may be necessary to prevent the infection from spreading.

Take home message: try not to get gas gangrene because at best you may lose a limb, and since it is quickly spreading, this is often fatal.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000620.htm

http://en.wikipedia.org/wiki/Clostridium_perfringens

http://www.mdguidelines.com/gangrene

A Brief History of Gangrene

Gangrene has a unique and storied history; one that ties in closely with that of America’s bloody past.

The first documented case occurred in 1194 AD, when Duke Leopold of Austria contracted the disease in his foot after it had been crushed by his horse.  It wasn’t until almost seven centuries later, however, that the disease fully took hold as a widespread and serious problem. The decade of the 1960s proved to have the highest number of recorded cases in history.

Playing a key role in this problem was the American Civil War and the unsanitary conditions that the soldiers would have dealt with. The conditions inside many surgical wards were so poor, the term “hospital gangrene” was coined, as many soldiers contracted the disease during their stay there. Because of the extreme trauma of war injuries, amputation was often necessary, and the large wounds left behind were very susceptible to infection.

Patients were subject not only to poor sanitation but also poor practice by surgeons. The importance of handwashing and the sterilization of surgical instruments was simply not common knowledge. Because of the horrible nature of the gangrene infections that patients contracted, people realized that a change was necessary in surgical protocol. It wasn’t until 1865 that antiseptics were commonly used in surgery, which was a practice that was pioneered by English surgeon Joseph Lister. This did not eradicate all instances of hospital-borne infection, but it was a huge step forward. We can thank gangrene for (indirectly) improving the standards and safety of surgery.   The so-called “Hospital Gangrene” of the Civil War is considered an extinct disease now.

References:

http://ehistory.osu.edu/uscw/features/medicine/cwsurgeon/amputations.cfm

Why is it important to know about gangrene?

Have you ever been out in the snow with less than adequate clothing to protect you from harsh temperatures?  Or, maybe you suffer from diabetes and have numbness in your toe and don’t realize that have injured it in some way. These are two common ways in which gangrene can begin to infect a host.  Since this is a class on infectious diseases, we will be focusing on wet and gas gangrene, which are caused by bacterial infections, specifically Clostridium perfringens. One way that this gram + bacteria causes infection is through surgical or other wounds in which the surrounding area of tissue doesn’t have enough blood flow to the area.  This creates an environment where C. perfringens can thrive.  When this happens, one may notice a discoloration of the skin followed by a sore that makes a crackling sound when pressure is applied to it.  This indicates the presence of gas inside the wound which is a good indication of gangrene.

Here’s a fine example of a personal experience with gangrene, which may bring this closer to home.  At my (Shaun) home in Kahoka, MO, I have a pet goat named Cosmo.  One day, Cosmo was messing around and got hung up when her leg got caught in her pen. The resulting wound was treated by a Vet, then wrapped, and we thought Cosmo would be getting better. After a while, it appeared that Cosmo wasn’t getting any better and the wound wasn’t looking very good.  One a trip back to the vet a month or so later, Cosmo got anxious in the car and tried to jump over the seat.  When this happened, her leg snapped right off.  She had a gangrene infection that ended in her losing her leg and making it decompose to the point of being able to break off with light pressure.

 

Sources:

http://www.ebi.ac.uk/2can/genomes/bacteria/Clostridium_perfringens.html

http://www.mayoclinic.com/health/gangrene/DS00993/DSECTION=causes

Welcome to our blog!

Hello.  Here you will find the semester long project updates for Alex Balis and Shaun Penechar.  We chose gangrene as our disease of interest. Throughout the next few days we will be updating with posts that you may find interesting relating to bacterial gangrene.  We hope you enjoy.  For now, here are some links where you can find more information:

http://www.medicinenet.com/gangrene/article.htm

http://www.fda.gov/Food/FoodSafety/Foodborneillness/FoodborneillnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070483.htm

http://www.google.com/search?q=history+of+gangrene&hl=en&safe=off&client=firefox-a&sa=G&tbo=p&rls=org.mozilla:en-US:official&channel=s&tbs=tl:1,tll:1800,tlh:1899&ei=0LO8S6XoMtPhnAf5wZjICA&oi=timeline_histogram_nav&ct=timeline-histogram&cd=8&ved=0CFIQyQEoCA

These are a few of our sources, which may be helpful for you to learn more as we continue to update this blog.

Enjoy!