Postoperative infection around a colostomy with crepitus suggests a gas-forming organism. Which organism is most likely responsible?

• A. Staphylococcus aureus
• B. Clostridium perfringens
• C. Pseudomonas aeruginosa
• D. Escherichia coli

Answer: (B)

Gas production in a postoperative wound points to a gas-forming infection, and the organism most likely is Clostridium perfringens. This anaerobic, spore-forming gram-positive rod rapidly invades devitalized tissue and releases toxins, especially alpha toxin, which destroys cell membranes and promotes systemic spread. The gas produced by fermentation accumulates in soft tissues, causing the palpable crepitus you’re seeing. Management requires urgent surgical debridement of necrotic tissue and broad-spectrum antibiotics effective against anaerobes (for example, penicillin with clindamycin), with hyperbaric oxygen as an adjunct in selected cases. While other pathogens can cause wound infections, they typically don’t produce the characteristic gas and crepitus seen with clostridial infection.