Gangrene pathophysiology: Difference between revisions
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===Gas Gangrene=== | ===Gas Gangrene=== | ||
* | *''[[Group A Steptococcus]]'' and [[exotoxins]] from ''[[Clostridium perfringens]]'' are responsible for the local and [[systemic infection]] found in [[gas gangrene]]. <ref name="pmid1884064">{{cite journal| author=Lehner PJ, Powell H| title=Gas gangrene. | journal=BMJ | year= 1991 | volume= 303 | issue= 6796 | pages= 240-2 | pmid=1884064 | doi=10.1136/bmj.303.6796.240 | pmc=1670510 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1884064 }} </ref> | ||
*[[Alpha-toxin]] is a ''[[Clostridium]]''- [[lecithinase]] produced by ''[[Clostridium perfringens]]'' that contributes to [[tissue necrosis]] and [[systemic]] [[hemolysis]].<ref name="pmid26631369">{{cite journal| author=Yang Z, Hu J, Qu Y, Sun F, Leng X, Li H | display-authors=etal| title=Interventions for treating gas gangrene. | journal=Cochrane Database Syst Rev | year= 2015 | volume= | issue= 12 | pages= CD010577 | pmid=26631369 | doi=10.1002/14651858.CD010577.pub2 | pmc=8652263 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26631369 }} </ref><ref name="pmid15632295">{{cite journal| author=Sakurai J, Nagahama M, Oda M| title=Clostridium perfringens alpha-toxin: characterization and mode of action. | journal=J Biochem | year= 2004 | volume= 136 | issue= 5 | pages= 569-74 | pmid=15632295 | doi=10.1093/jb/mvh161 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15632295 }} </ref> | *[[Alpha-toxin]] is a ''[[Clostridium]]''- [[lecithinase]] produced by ''[[Clostridium perfringens]]'' that contributes to [[tissue necrosis]] and [[systemic]] [[hemolysis]].<ref name="pmid26631369">{{cite journal| author=Yang Z, Hu J, Qu Y, Sun F, Leng X, Li H | display-authors=etal| title=Interventions for treating gas gangrene. | journal=Cochrane Database Syst Rev | year= 2015 | volume= | issue= 12 | pages= CD010577 | pmid=26631369 | doi=10.1002/14651858.CD010577.pub2 | pmc=8652263 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26631369 }} </ref><ref name="pmid15632295">{{cite journal| author=Sakurai J, Nagahama M, Oda M| title=Clostridium perfringens alpha-toxin: characterization and mode of action. | journal=J Biochem | year= 2004 | volume= 136 | issue= 5 | pages= 569-74 | pmid=15632295 | doi=10.1093/jb/mvh161 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15632295 }} </ref> | ||
*Progression of this [[condition]] to [[shock]] is very rapid. | *Progression of this [[condition]] to [[shock]] is very rapid. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
There are three types of gangrene and they have different pathophysiology. A reduced arterial perfusion is observed in dry gangrene which results in the compensatory arteriolar dilation , which eventually results in distal edema, and damage of the endothelial tissue. [1] Saprogenic microorganisms such as Clostridium perfringens and Bacillus fusiformis are the most common organisms observed in wet gangrene which are responsible for infecting the tissues, thereby producing a putrid smell and edema. [2] Group A Steptococcus and exotoxins from Clostridium perfringens are responsible for the local and systemic infection found in gas gangrene.[3]
Pathophysiology
There are three types of gangrene and they have different pathophysiology.
Dry Gangrene
- A reduced arterial perfusion is observed in dry gangrene which results in the compensatory arteriolar dilation , which eventually results in distal edema, and damage of the endothelial tissue. [1]
- It is a type of coagulative necrosis which occurs in ischemic tissue.
Wet Gangrene
- Saprogenic microorganisms such as Clostridium perfringens and Bacillus fusiformis are the most common organisms observed in wet gangrene which are responsible for infecting the tissues, thereby producing a putrid smell and edema. [2]
- The pooling and accumulation of blood in the affected tissue promotes proliferation of bacteria.
- An edematous, putrid, soft and dark tissue is observed.[2]
Gas Gangrene
- Group A Steptococcus and exotoxins from Clostridium perfringens are responsible for the local and systemic infection found in gas gangrene. [3]
- Alpha-toxin is a Clostridium- lecithinase produced by Clostridium perfringens that contributes to tissue necrosis and systemic hemolysis.[4][5]
- Progression of this condition to shock is very rapid.
References
- ↑ 1.0 1.1 "StatPearls". 2022. PMID 32809387 Check
|pmid=value (help). - ↑ 2.0 2.1 2.2 Al Wahbi A (2018). "Autoamputation of diabetic toe with dry gangrene: a myth or a fact?". Diabetes Metab Syndr Obes. 11: 255–264. doi:10.2147/DMSO.S164199. PMC 5987754. PMID 29910628.
- ↑ 3.0 3.1 Lehner PJ, Powell H (1991). "Gas gangrene". BMJ. 303 (6796): 240–2. doi:10.1136/bmj.303.6796.240. PMC 1670510. PMID 1884064.
- ↑ Yang Z, Hu J, Qu Y, Sun F, Leng X, Li H; et al. (2015). "Interventions for treating gas gangrene". Cochrane Database Syst Rev (12): CD010577. doi:10.1002/14651858.CD010577.pub2. PMC 8652263 Check
|pmc=value (help). PMID 26631369. - ↑ Sakurai J, Nagahama M, Oda M (2004). "Clostridium perfringens alpha-toxin: characterization and mode of action". J Biochem. 136 (5): 569–74. doi:10.1093/jb/mvh161. PMID 15632295.