The role of clostridial toxins in the pathogenesis of gas gangrene.
Clostridium perfringens gas gangrene is, without a doubt, the most fulminant necrotizing infection that affects humans. In victims of traumatic injury, the infection can become well established in as little as 6-8 h, and the destruction of adjacent healthy muscle can progress several inches per hour despite appropriate antibiotic coverage. Shock and organ failure are present in 50% of patients and, among these, 40% die. Despite modern medical advances and intensive-care regimens, radical amputation remains the single best life-saving treatment. Over the past century, much has been learned about the pathogenesis of this disease, and novel therapies are on the horizon for patients with this devastating infection.
Stevens
Dennis L
DL
Veterans Affairs Medical Center, Boise, ID, USA; and University of Washington School of Medicine, Seattle, WA, USA. dlsteven@mindspring.com
Bryant
Amy E
AE
D001427:Bacterial Toxins / Q000633:toxicity*; D003016:Clostridium perfringens / Q000737:chemistry* / Q000472:pathogenicity; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005738:Gas Gangrene / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007249:Inflammation / Q000209:etiology; D009102:Multiple Organ Failure / Q000209:etiology; D009336:Necrosis; D009504:Neutrophils / Q000187:drug effects
D001427:Bacterial Toxins