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Myonecrosis is the death of muscle tissue in a localized area because of trauma, infection, or infarction, where the blood supply is cut off. The two most common causes of this condition are diabetes complications and infection with Clostridium bacteria, leading to a very dangerous medical condition known as gas gangrene. Depending on the cause, it is possible for myonecrosis to result in significant medical complications, including death.
When only superficial muscle tissue is involved, the patient may experience pitting, where the muscle dies off and shrinks, leaving bumps in the skin. Usually the patient retains control of the involved limb, although coordination and muscle strength may be lower. If myonecrosis travels deep into the muscle tissue, it is possible to lose the limb, as the muscle below the site of the tissue death will also cease to function.
In diabetes, some patients experience circulatory breakdowns, especially in their legs. This can cause myonecrosis, because the muscles do not get enough oxygen and nutrients to survive. Patients typically notice decreased sensation in the leg first, and may experience a sharp, stabbing pain in the area where the muscle tissue dies. Surgery may be necessary to remove the dead tissue, and the patient needs follow-up care to prevent further muscle damage. This may include dietary changes and exercise modifications to promote better circulation in the area.
With gas gangrene, bacteria penetrate the muscle tissue, causing inflammation. The area swells rapidly, filling with gas bubbles, and the tissue dies. As the bacteria spread, the patient can die from the infection. Treatment may require amputating the involved limb to halt the gas gangrene. In cases where this becomes necessary, the muscles in the limb are usually so badly damaged from the episode of myonecrosis that even if it were possible to preserve the limb, function would be limited.
Signs of muscle cell death can include pain, a smelly discharge, heat, and changes in skin color or texture. The patient may also notice muscle weakness and tingling. It is important to receive prompt medical evaluation to determine the cause and provide appropriate treatment. The sooner a doctor starts caring for the patient, the greater the chances of a good outcome. People with diabetes should be alert to signs of injury in case they are developing diabetic neuropathy, a complication where the peripheral nervous system starts to break down and patients totally lose sensation in their extremities.
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