Question

Charles is a retired bus driver who developed type 2 diabetes over 10 years ago. Since his retirement, his lifestyle has become very sedentary and he has put on a substantial amount of weight. Although he has felt tingling and numbness in his left foot for a while, he has not been worried because he thought his foot was simply “falling asleep.” Recently, a scratch on his foot does not seem to be healing and is becoming increasingly ugly. Because the sore did not bother him much, Charles figured it could not be serious until his daughter noticed a purplish discoloration spreading on the skin and oozing. When he was finally seen by his physician, Charles was rushed to the operating room. His open sore, or ulcer, is the result of a diabetic foot.The concern here is that gas gangrene may have taken hold in the dead tissue. The most likely agent of gas gangrene is Clostridium perfringens, an endospore-forming, gram-positive bacterium. It is an obligate anaerobe that grows in tissue devoid of oxygen. Since dead tissue is no longer supplied with oxygen by the circulatory system, the dead tissue provides pockets of ideal environment for the growth of C. perfringens.A surgeon examines the ulcer and radiographs of Charles’s foot and determines that the bone is not yet infected. The wound will have to be surgically debrided (debridement refers to the removal of dead and infected tissue) and a sample sent for microbiological lab analysis, but Charles will not have to have his foot amputated. Many diabetic patients are not so lucky. In 2008, nearly 70,000 diabetic patients in the United States lost a foot or limb to amputation, according to statistics from the Centers for Disease Control and Prevention.[1]Which growth conditions would you recommend for the detection of C. perfringens?

Answer 1

Clostridium perfringes usually affects diabetics and is one of the causative gram positive organism . It arises in traumatised tissue and seen as diabetic feet affecting lower external of diabetics.

Growth conditions for detection of C.perfringens:

Clostridium perfringes prefer to grow in conditions with little or no oxygen.

A person develops a fever associated with chills, pain and inflammation at the site of infection. If these symptoms is seen the person should be treated immediately with antibiotics or else the person may go into sepsis and shock. Initially the person may develop purplish discoloration which may extend if left untreated and starts to ooze the dusty fluid.

The discharge from the wound looks like dishwater and it as musty odour.

The wound when not taken care of reaches a larger tissues and even affecting subcutaneous fat and even muscles. If nerves are affected, the pain severity may be less.

A person with cellulitis infection who develops additional skin symptoms like dusty looking skin and discharge have to be evaluated for C.perfringens infection.

Along with these growth conditions to identify Clostridium perfringes, blood studies like CBC, blood culture tests detect the presence of this organism.

Early identification of this organism is important to prevent further complications which even lead to amputation.

Thank you..