What is the Difference Between Gas Gangrene and Necrotizing Fasciitis

The key difference between gas gangrene and necrotizing fasciitis is that gas gangrene is a type of bacterial skin infection that is commonly caused by Clostridium perfringens, while necrotizing fasciitis is a type of bacterial skin infection that is commonly caused by group A Streptococcus.

Some bacteria live on normal skin without causing any harm. Some bacteria, on the other hand, invade the normal skin, broken skin, or wounds and cause bacterial skin infections such as folliculitis, furunculosis and abscesses, impetigo, cellulitis, erysipelas, gas gangrene, and necrotizing fasciitis. Gas gangrene and necrotizing fasciitis are two bacterial skin infections.

CONTENTS

1. Overview and Key Difference
2. What is Gas Gangrene 
3. What is Necrotizing Fasciitis
4. Similarities – Gas Gangrene and Necrotizing Fasciitis
5. Gas Gangrene vs Necrotizing Fasciitis in Tabular Form
6. Summary – Gas Gangrene vs Necrotizing Fasciitis

What is Gas Gangrene?

Gas gangrene is a type of bacterial skin infection that is commonly caused by Clostridium perfringens. Gas gangrene normally affects deep muscle tissue. In this condition, the surface of the skin may look normal at first. As the condition progresses or worsens, the skin may become pale and later turns to other colors, such as grey or purplish red. The skin may also look bubbly. It may also make a crackling sound when you press on it because of the gas within the tissue. Bacteria typically gather in an injury or surgical wounds that have no blood supply in this condition. The bacterial infection produces toxins that release gas and cause tissue death. Moreover, like wet gangrene, gas gangrene is also a very life-threatening condition. The risk factors for this condition may include diabetes, blood vessel disease, severe injury, smoking, obesity, immunosuppression, injections, and COVID-19 complications. Gas gangrene can also cause some complications, such as scarring and removal of a body part to save a life.

Gas gangrene can be diagnosed through physical examination, blood tests, fluid or tissue culture, and imaging tests (CT scan, MRI, and X-ray). Furthermore, treatment options for gas gangrene include antibiotics taken intravenously or by mouth, surgery, and other procedures (debridement, vascular surgery, amputation, and skin grafting), and hyperbaric oxygen surgery.

What is Necrotizing Fasciitis?

Necrotizing fasciitis is a type of bacterial skin infection that is commonly caused by group A Streptococcus, such as Streptococcus pyogenes. This is the same bacterium that causes strep throat. Necrotizing fasciitis occurs when this bacterium infects the superficial fascia: a layer of connective tissue below the skin. S. pyogenes normally transmit through puncture wounds, burns, minor cuts, insect bites, and abrasions. The normal symptoms of necrotizing fasciitis include increasing pain in the skin opening, pain that is more intense than would be expected from the appearance, redness and warmth around the affected area, flu-like symptoms such as diarrhoea, nausea, fever, dizziness, weakness, malaise, and dehydration due to intense thirst.

The severe symptoms that result from necrotizing fasciitis include a purplish rash, blisters filled with dark foul-smelling fluid, gangrene, a severe drop in blood pressure, toxic shock, and unconsciousness. In addition, serious complications are common in this condition. These may include sepsis, shock, organ failure, loss of an arm or leg due to amputation, severe scarring, and death. Moreover, having a weakened immunity and certain diseases or conditions can increase the risk of necrotizing fasciitis. The health conditions that increase the risk for necrotizing fasciitis include alcohol use, cancer, chickenpox, cirrhosis, diabetes, heart disease, chronic kidney disease, lung disease, peripheral vascular disease, and steroid use.

Necrotizing fasciitis is diagnosed through physical examination, blood test, tissue biopsy, and CT scan. Furthermore, treatment options for necrotizing fasciitis are intravenous antibiotic therapy, surgery to remove damaged or dead tissue, medications to raise blood pressure, amputation of affected limbs, hyperbaric oxygen therapy, cardiac monitoring and breathing aids, blood transfusions, and giving intravenous immunoglobulins.

What are the Similarities Between Gas Gangrene and Necrotizing Fasciitis?

• Gas gangrene and necrotizing fasciitis are two bacterial skin infections.
• The causative agents of both skin infections transmit through skin openings.
• Both these skin infections may have similar symptoms, such as purple or red color rash, pain in the affected area, and weakness.
• Gas gangrene is a severe symptom of necrotizing fasciitis.
• Both these skin infections can be diagnosed through physical examination, blood tests, and imaging tests.
• They are mainly treated through antibiotics, medications, surgery, and hyperbaric oxygen treatment.

What is the Difference Between Gas Gangrene and Necrotizing Fasciitis?

Gas gangrene is a type of bacterial skin infection that is commonly caused by Clostridium perfringens, while necrotizing fasciitis is a type of bacterial skin infection that is commonly caused by group A Streptococcus. Thus, this is the key difference between gas gangrene and necrotizing fasciitis. Furthermore, risk factors for gas gangrene include diabetes, blood vessel disease, severe injury, smoking, obesity, immunosuppression, injections, and COVID-19 complications. On the other hand, the risk factors for necrotizing fasciitis include having a weakened immunity and certain diseases or conditions.

The below infographic presents the differences between gas gangrene and necrotizing fasciitis in tabular form for side-by-side comparison.

Summary – Gas Gangrene vs Necrotizing Fasciitis

Gas gangrene and necrotizing fasciitis are two bacterial skin infections. The causative agents of both skin infections transmit through skin openings and may cause similar symptoms such as purple or red color rash, pain in the affected area, weakness, etc. Gas gangrene is commonly caused by Clostridium perfringens, while necrotizing fasciitis is commonly caused by group A Streptococcus. So, this is the key difference between gas gangrene and necrotizing fasciitis.

Reference:

1. “Gangrene.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 17 June 2022.
2. “Necrotizing Fasciitis (Flesh-Eating Bacteria): Causes, Symptoms, and Treatment.” WebMD.

Image Courtesy:

1. “Gas gangrene pathology slide” By Engelbert Schröpfer, Stephan Rauthe and Thomas Meyer. – Diagnosis and misdiagnosis of necrotizing soft tissue infections: three case reports. Cases J 2008, 1:252. doi: 10.1186/1757-1626-1-252 (CC BY 2.0) via Commons Wikimedia
2. “Necrotizing fasciitis – intermed mag”  By Nephron – Own work (CC BY-SA 3.0) via Commons Wikimedia