Gas gangrene was a common occurrence until the middle of the 20th century when war injuries were exposed to spores containing the causative bacteria present in soil. During the Civil War in the USA nearly half of the soldiers receiving gunshot wounds developed infection with many progressing to gas gangrene.
The primary organism causing gas gangrene is Clostridium perfringens. The spores of the bacteria are carried in animal feces and are present in the soil.
Other organisms that lead to gangrene in these conditions include Group A Streptococci and Staphylococci, C. histolyticum or other Clostridium spp. Gas gangrene has become uncommon in modern warfare due to better surgical management and treatment.
Traumatic gas gangrene is caused after a deep, penetrating injury like a knife or a gunshot wound or a car crash. This type of trauma accounts for about 70% of cases of gas gangrene and Clostridium perfringens is found in about 80% of such infections. Other organisms are:
- C. septicum,
- C. novyi,
- C. histolyticum,
- C. bifermentans,
- C. tertium
- C. fallax.
Necrotizing fasciitis (Type II) is also called streprtococcal gas gangrene and is caused due to group A streptococci. This is seen in those who have sustained an injury with a blunt instrument, after child birth, long term intravenous drug abuse or penetrating injury such as caused by a laceration or a surgical procedure.