Myonecrosis: Treatment, Cost and Side Effects

Myonecrosis or clostridial myonecrosis is a bacterial infection that produces gas in tissues in gangrene. Therefore, it can also be termed as gas gangrene. It is a life-threatening condition caused by Clostridium perfringens bacteria.

A normal gangrene is characterised by death of tissues or blood vessels (necrosis) in a particular region of the body. They mainly occur due to severe wounds or injury that has been exposed for a longer period of time. Therefore, it can be said that gas gangrene is a more severe form of gangrene that is an immediate medical emergency. The point of differentiation lies in the fact that gas gangrene occurs in deep muscle tissue due to the production of toxins or exotoxins by Clostridium perfringens bacterium or soil-borne anaerobic bacteria. These microorganisms enter the body through significant skin breakage. As a result of which it was pretty widespread among soldiers in the 20th century, because of nonsterile field surgery and lack of antibiotics.

Gas gangrene can also be caused without an outside injury or wound. Non-traumatic myonecrosis is caused by envenomation by snakes of the Bothrops genus (family Viperidae), type II diabetes, arterial disease, colon cancer, frostbite, open fractures and use of a contaminated needle to inject substances into your muscles.

Gas gangrene is generally characterized by necrosis (muscle tissue death), gas production and sepsis (life-threatening condition where the infection causes injury to the tissue and organs of the body). Early manifestation of the disease can be seen in the form of fever, swelling of the skin which can turn pale and the colour varies from dark red-purple to red-black. Therefore, it can lead to system wide shock and damage of a person’s immune system. Therefore, it is not always possible for proper diagnosis due to the nature of the disease. However, if diagnosis is done, then it will include skin culture, blood tests and imaging tests like X-ray and MRI.

The nature of the disease necessitates a quick treatment to prevent the condition from turning into a life-threatening condition. Often gas gangrene requires removal of the dead or infected tissues through surgical or chemical or mechanical or by maggot therapy (debridement and excision). Administered water-soluble antibiotics are also given through vein but are not effective in treating low oxygen supply in the body (ischaemic muscles). However, in severe cases, gas gangrene may need amputation of the limb or affected body part to prevent the infection from spreading to the rest of the body. You may be fitted with a prosthetic limb to help you with physical mobility and movement.

Recently, doctors and medical professional are using hyperbaric oxygen therapy to treat gas gangrene. Oxygen is used in a pressurized chamber that saturates the infected tissues and prevents the growth of the bacteria. The important thing is get immediate medical help and treatment.

Gas gangrene can cause varied symptoms that are aggressive nature and can be fatal if not treated immediately. You will have necrosis (muscle tissue death) and gas production that will eventually lead to sepsis (low oxygen in the body). Moreover, the affected part (mostly the leg portion) will have swelling and turn pale in colour that can turn dark-purple or dark red black. The formation of blisters and subsequent discharge does not look like regular pus but is more water, often described as “sweetly putrid” or “dishwater pus”. Additional symptoms you can experience are fever, increased heart rate and vomiting.

Due to the nature of the disease and the associated symptoms, it becomes imperative to go an emergency room as delayed treatment can be life-threatening.

Gangrene and gas gangrene is a serious condition that requires amputation or debridement. Therefore, people having minor infection or cuts which can be cured by antibiotics and ointment does not require amputation or debridement.

As treatment for myonecrosis generally means amputation or debridement and excision, side effects are nil. However, gas gangrene or myonecrosis can be fatal and lead to many complications like shock, kidney failure, permanent tissue damage, jaundice, liver damage, widespread infection and even coma and death.

If you had amputation, then post-surgical process will include occupational and physical therapy to restore normal functioning of your legs. You will be given an artificial or prosthetic limb to help you in physical mobility and movement. Therefore, you might continuous support and training from a physical therapist to help you return to a normal life. You will also be assigned a nutritionist to help you in planning your meal that should include more proteins and vitamin C to help you heal faster.

It cannot be stressed enough that in the event of an injury or wound, you should immediately clean the wound region and seek medical supervision. Failure to do so can be fatal and life-threatening.

The period of recovery for myonecrosis is usually long as healing of tissues from debridement or amputation is long and followed by physical therapy to restore normal functioning of the limbs. It can take around 6 months to recover depending on the location and severity of the infection.

The cost of treating gas gangrene can range between Rs.10,000 to Rs.3,00,000, depending on the location and severity of the infection.

The treatment results for myonecrosis is positive. However, if left untreated the condition can be fatal and life-threatening.

There are no known alternative treatments for myenocrosis or gas gangrene.