Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Clostridium perfringens — Gas gangrene

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 5 November 2026 · Methodology

Clostridiaceae · Gram-positive anaerobe

Clostridium perfringens est l'agent principal de la gangrène gazeuse (myonécrose clostridiale) et de l'hémolyse intravasculaire massive. Deux urgences : (1) myonécrose clostridiale : débrider chirurgicalement dans les minutes qui suivent le diagnostic — l'amputation radicale reste le meilleur traitement salvateur (Stevens & Bryant 2002). (2) hémolyse intravasculaire fulminante : transfusion massive + échanges plasmatiques + réanimation. La présence de gaz dans les tissus mous (radio/TDM) est évocatrice mais non spécifique. Toxines alpha (lécithinase) = responsable de l'hémolyse massive, de la myonécrose et de la défaillance multiviscérale. L'oxygénothérapie hyperbare n'est pas recommandée par IDSA 2014 (bénéfice non démontré, risque de retarder réanimation et débridement).

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Clostridium perfringens are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Skin (myonécrose clostridiale)	High tropism	Evidence B	2	direct (derived from the card text)
Colon / Alimentary system (entérite nécrosante / intoxication alimentaire)	High tropism	Evidence B	3	not recorded
Liver / Bile duct (hémolyse fulminante)	High tropism	Evidence C	1	not recorded
Uterus (sepsis post-abortum)	Moderate tropism	Evidence C	1	not recorded

Spread routes recorded: 1 of 4 documented foci (including 1 derived from the card text) A focus without a route is not a focus without spread: the route is simply not recorded.

Associated syndromes

• Bacterial skin infections

Sources

• Stevens DL & Bryant — Necrotizing Fasciitis (NEJM) (2017) — doi:10.1056/NEJMra1600673
• IDSA — SSTI Practice Guidelines (2014) — doi:10.1093/cid/ciu296
• IDSA — Intra-abdominal Infections Guidelines (2010) — doi:10.1086/649554
• Mazuski JE et al. — The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection (Surg Infect) (2017) — doi:10.1089/sur.2016.261
• Stevens DL & Bryant AE — The role of clostridial toxins in the pathogenesis of gas gangrene (Clin Infect Dis) (2002) — doi:10.1086/341928

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