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Clostridial myonecrosis

Dennis L Stevens, MD, PhD
Amy Bryant, PhD
Section Editor
John G Bartlett, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Clostridial myonecrosis (gas gangrene) is a life-threatening muscle infection that develops either contiguously from an area of trauma or hematogenously from the gastrointestinal tract with muscle seeding. Early recognition and aggressive treatment are essential.

There are two major presentations of clostridial gas gangrene: traumatic and spontaneous. Traumatic gas gangrene is most commonly caused by Clostridium perfringens; spontaneous gangrene is most commonly caused by Clostridium septicum.

Issues related to necrotizing muscle infections due to Clostridium species will be reviewed here. Issues related to streptococcal necrotizing myositis and infections involving the skin and fascia are discussed separately. (See "Necrotizing soft tissue infections".)


Clostridium species are widespread in nature due to their ability to form endospores. They are commonly found in soil and marine sediments as well as human and animal intestinal tracts. Categories of clostridial soft tissue infections include wound contamination, anaerobic cellulitis, myonecrosis (gas gangrene), and necrotizing fasciitis [1].

Wound contamination with soil containing clostridial spores or vegetative organisms may occur, although contamination with clostridial species in the absence of devitalized tissue does not necessarily lead to infection. In one study, for example, 30 to 80 percent of open traumatic wounds were contaminated with clostridial species [2].

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Literature review current through: Nov 2017. | This topic last updated: Oct 03, 2017.
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