Necrotizing anaerobic infections.

Severe necrotizing anaerobic infections carry a high mortality. From a retrospective review of 17 cases of gas gangrene, necrotizing fasciitis and nonclostridial myonecrosis seen at the Victoria and University hospitals in London, Ontario, between Jan. 1, 1975 and Dec. 31, 1977, the most common antecedent was found to be minor trauma. Location of the infection varied; the scrotum and perineum were most commonly involved. Local findings were most frequently edema, skin tenderness and induration. Mixed infections predominated with a pure growth of Clostridium sp. occurring in only three cases. The overall mortality was 29%. The mainstay of treatment after initial administration of fluids followed by broad-spectrum antibiotics is early aggressive surgical debridement of all necrotic tissue.