Gangrene – Symptoms and Causes

Overview

Gangrene occurs when body tissue dies due to poor blood circulation or severe bacterial infection. This condition typically affects extremities like fingers, toes, arms, and legs, but can also develop in internal organs such as the gallbladder and muscle tissue.

People with conditions that impair blood vessels function—particularly diabetes and atherosclerosis (hardened arteries)—face higher risks of developing gangrene.

Treatment options include:

• Antibiotic therapy to fight bacterial infections.
• Oxygen therapy to improve tissue healing.
• Surgical interventions to restore proper blood flow, remove dead tissue, and prevent spread of infection.

Early detection and prompt medical attention significantly improve recovery outcomes. If you notice signs of tissue death or infection, seek immediate medical care.

Signs and Symptoms

Gangrene affecting the skin often shows several visible changes. The skin color may change from pale gray to blue, purple, black, bronze, or red. The affected area might also swell, develop blisters, or feel unusually cool to the touch.

People with gangrene typically experience sudden, severe pain that later changes to numbness. You might notice a bad smell coming from the affected area. The skin may appear thin and shiny, or you might see areas without hair.

When gangrene develops beneath the skin (gas gangrene) or in internal organs, additional symptoms can include a mild fever and general discomfort.

If infection spreads throughout the body, septic shock may develop. Signs of this serious condition include:

• Low blood pressure
• Fever (though some people have temperatures below 98.6°F/37°C)
• Fast heartbeat
• Dizziness
• Trouble breathing
• Mental confusion

When to See a Doctor

Gangrene requires immediate medical attention, as it can indicate a life-threatening situation. Contact your healthcare provider right away if you experience ongoing, unexplained pain along with any of these warning signs:

• Fever that doesn’t go away
• Skin changes that persist (discoloration, warmth, swelling, blisters)
• Bad-smelling discharge from a wound
• Sudden pain around a recent surgery or injury site
• Skin that feels cold, hard, pale, and numb

Don’t wait to seek treatment if you notice these symptoms, especially if you have diabetes, blood vessel disease, or a weakened immune system.

What Causes Gangrene?

Gangrene develops when tissue dies due to several possible factors. The main causes include poor blood circulation, which deprives cells of oxygen and nutrients they need to survive.

Bacterial infections can also lead to gangrene, especially when they remain untreated. Serious injuries, such as those from accidents or gunshots, create openings for bacteria to enter the body and potentially cause gangrene if not properly treated.

The feet are especially vulnerable to gangrene. When blood cannot reach the toes or other parts of the foot, the tissue begins to die.

People with diabetes face a higher risk of foot gangrene because they may have poor circulation and nerve damage. These issues make it hard to feel injuries, which can then become infected.

Different Types of Gangrene

Dry Gangrene

• Appears as dry, shriveled skin
• Skin color ranges from brown to purplish-blue or black
• Develops gradually
• Common in people with diabetes or blood vessel diseases

Wet Gangrene

• Involves bacterial infection of the tissue
• Shows swelling and blistering with a moist appearance
• Can develop after burns, frostbite, or injuries
• Spreads quickly and can be life-threatening
• Requires immediate medical attention

Gas Gangrene

• Affects deep muscle tissues
• Skin may look normal at first
• Later turns pale, gray, or purplish-red
• Skin may appear bubbly
• Makes a crackling sound when pressed due to gas in tissues
• Usually caused by Clostridium perfringens bacteria
• Life-threatening condition requiring urgent care

Internal Gangrene

• Affects internal organs like intestines or gallbladder
• Happens when blood flow to an organ is blocked
• Can occur if intestines twist through a hernia
• Can be fatal without treatment

Fournier’s Gangrene

• Affects genital organs
• More common in men but can affect women too
• Results from infections in the genital area or urinary tract

Meleney’s Gangrene

• Rare type that typically follows surgery
• Painful skin lesions appear 1-2 weeks after surgery
• Also called progressive bacterial synergistic gangrene

Understanding these different types helps doctors provide the right treatment quickly.

Risk Factors

Several factors can raise your chance of developing gangrene:

• Diabetes damages blood vessels over time when blood sugar stays high. This damage slows blood flow to body tissues.
• Blood vessel problems like atherosclerosis (hardened arteries) and blood clots can block normal blood flow.
• Injuries and surgical procedures damage skin and tissues, creating entry points for infection. People with poor circulation face higher risks after injuries.
• Tobacco use significantly increases gangrene risk by further restricting blood flow.
• Excess weight puts pressure on blood vessels, reducing circulation and making infections more likely to develop.
• Weakened immune system from:
  • Cancer treatments (chemotherapy, radiation)
  • Infections like HIV
  • Certain medications
• Injectable substances have rarely been connected to gangrene-causing bacterial infections.
• COVID-19 complications may be linked to dry gangrene in fingers and toes. Some patients developed blood clotting issues that reduced blood flow to extremities, though researchers need to study this connection further.

People with multiple risk factors should be especially careful about symptoms like pain, skin color changes, or unusual sensations in their extremities, as early treatment greatly improves outcomes.

Complications

If not treated right away, gangrene can cause serious problems. The infection can spread quickly to other parts of the body.

In severe cases, doctors may need to remove (amputate) the infected body part to prevent the spread and save the patient’s life.

After removing infected tissue, patients might be left with scars. Some people may need reconstructive surgery to repair the affected area.

Prevention

Preventing gangrene involves several proactive steps that can reduce your risk factors.

Managing Health Conditions

People with diabetes should monitor blood sugar levels carefully. Daily examination of hands and feet for cuts, sores, or infection signs is crucial. Yearly professional examinations are also recommended.

Weight Management

Excess weight increases diabetes risk and puts pressure on arteries, which slows blood flow. This decreased circulation can lead to infection and slow healing of wounds.

Avoid Tobacco Products

Long-term tobacco use damages blood vessels and impairs circulation, creating favorable conditions for gangrene development.

Practice Good Hygiene

Make sure to wash wounds with mild soap and water. Also, keep injured areas clean and dry. Finally, allow wounds to heal completely.

Be Aware of Temperature-Related Risks

After exposure to cold temperatures, check for signs of frostbite such as pale, hard, cold, or numb skin. Frostbite reduces blood flow to affected areas, potentially leading to tissue damage.