<prompt> Which of the following is not true of gas gangrene?It is caused by clostridium perfringensClostridium perfringens is a gram-negative spore-bearing bacillusGas gangrene is characterized by severe local pain, crepitus and signs of toxemiaHigh dose penicillin and aggressive debridement of affected tissue is the treatment of established infection  <response>: Ans is b i.e. clostridium perfringens is a gram negative spore bearing bacillus Clostridium perfringens is gram positive , spore bearing, obligate anaerobe. Features of gas gangrene clostridial myonecrosis Causative agents - Clostridium perfringens Clostridium novyi - Clostridium septicum - Clostridium histolyticum Signs and symptoms - Gas gangrene begins with the sudden onset of pain feature differentiating if from cellulitis - Tachycardia but no elevation in temperature - Gas is not seen in early stage Skin is tense, white often marbled with blue. It is cooler than normal. - The symptoms progress rapidly; swelling edema, and toxemia increase, and a profuse serous discharge, which may have a peculiar sweetish smell, appears. Appearance of gas produces body crepitations Management: ? - Surgical debridement fasciotomy is done immediately - Antibiotics -- penicillin clindamycin - Polyvalent gas gangrene antitoxin controversial - Hyperbaric oxygen therapy controversial 