Boating injury

[getting99]

Following a boating injury a 35 year old man presented with fever and tackycardia. Examination revealed a wide erythema around a blistering and draining wound in the flank. X ray shows gas in the soft tissues.
Which of the following measures is most appropriate?
a- give antifungal
b- give antitoxin
c- administer hyperbaric oxygen
d- wide debridement
e- early wound closure

[Evgeniy]

Is it antitoxin! is there a risk of tetanus here

[DrSeddik]

This is gas gangrene I guess (cl. perfringes)..

I think debridement, because hyperbaric oxygen would take time.

[HouseWannabe]

It's a case of gas gangrene so you would have to debride then treat with the hyperbaric oxygen. Debriment alone won't treat it... and Hyperbaric oxygen alone also won't treat. So I am not sure on this one...i think C is the answer just because i am assuming that debriment has already been done, and now they're treating..

[getting99]

This is definitely a gas gangrene due to production of insoluble gases by the anaerobic bacteria such as hydrogen and methane.
Although clostridial has been pinned to this condition but in reality it's other facultative and obligate anaerobes that cause the infection specially streptococci.
The ideal treatment is wide debridement and delayed wound closure. The use of hyperbaric oxygen is questionable as it has not shown consistent results and it's not available in every medical facility.

So guys your answers were correct

[GNND85]

Also remember that Clostridium species are implicated in drug addicts taking "black tar heroin"