Key result
Appropriate therapy limits mortality to ~4% in diabetic patients with nonclostridial gas infections.
Why the study?
Nonclostridial gas gangrene is infrequently reported and considered relatively rare, requiring better characterization in diabetic patients with orthopedic vascular problems.
What is the incidence and clinical outcome of nonclostridial gas gangrene in diabetic patients with orthopedic vascular problems?
Observational (n=278)
What is the incidence and clinical outcome of nonclostridial gas gangrene in diabetic patients with orthopedic vascular problems?
Absolute Event Rate: 17% vs 3%
Nonclostridial gas gangrene is relatively common in diabetic patients with orthopedic vascular problems and has a favorable prognosis with appropriate antibiotic and surgical therapy.
Questions routine clostridial attribution for gas in diabetic tissues; leaves open need for prospective microbiologic studies.
Gangrenous lesions accompanied by evidence of subcutaneous gas usually are diagnosed as "clostridial gas gangrene." The occurrence of nonclostridial gas gangrene has been infrequently reported and is thought to be relatively rare. Review of 278 admissions of diabetic patients with orthopedic vascular problems disclosed a 17% (48 patients) incidence of nonclostridial gas infections and a 3% (one patient) occurrence of clostridial gas gangrene. Clinical characteristics ranged from severe to benign toxicity. Appreciation of the causative organisms (usually mixed Gram-negative rod and enterococcus) of this syndrome is essential, especially in the diabetic patient, since appropriate antibiotic therapy and surgery can result in a low mortality (4%) and a high incidence (80%) of ambulatory, independent patients.
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Alice N. Bessman (1975) conducted an observational in Diabetic patients with orthopedic vascular problems (n=278). Nonclostridial gas infections vs. Clostridial gas gangrene was evaluated on Incidence of nonclostridial gas infections. Nonclostridial gas infections occurred in 17% of diabetic patient admissions with orthopedic vascular problems, with appropriate therapy resulting in 4% mortality.
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