Background: Gas gangrene, or clostridial myonecrosis, is a rare but life-threatening complication of diabetic foot ulcers [DFU], characterized by rapid tissue necrosis and systemic toxicity due to Clostridium species.

Case Report: A 40-year-old male with poorly controlled type 2 diabetes [HbA1c 16.8%]presented with a 48-hour history of worsening right foot ulcer, fever, swelling, crepitus, and foul-smelling discharge. On examination, he was febrile [39°C], tachycardic, and hypotensive. Imaging revealed gas in soft tissue planes.

Lab: WBC 20,500/µL with neutrophilia. Wound culture isolated Clostridium perfringens.

Management: Emergency surgical debridement was performed within hours of admission. Broad-spectrum antibiotics including high-dose penicillin, clindamycin, and metronidazole were administered. Adjunctive hyperbaric oxygen therapy and intensive insulin therapy for strict glycemic control were instituted. Multiple debridements were done over 7 days. Outcome: The patient showed resolution of systemic symptoms, progressive wound healing, and successful limb salvage without amputation.

Conclusion: High clinical vigilance for gas gangrene in DFU is essential. Early diagnosis, aggressive surgical debridement, targeted antimicrobials, hyperbaric oxygen, and glycemic control are critical for limb salvage. Multidisciplinary management significantly reduces morbidity and mortality.

TBA