Clinical features appear within 24 hours of the injury.
A spreading gangrene of the muscles with profound toxaemia and shock; there is oedema with reddening and then blackening of muscles. Overlying skin has a marbled appearance before turning black and then sloughing. There is a foul smelling serous exudate.
Crepitus - a palpable crackling or bubbling - can often be detected under the skin due to gas production by clostridia. However, it is not pathognomic of infection nor invariably present.
Note that it is essential to distinguish gas gangrene, which is characterized by myonecrosis, from anaerobic cellulitis, in which superficial gas formation is abundant but toxaemia usually slight.
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