[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$fxLN3MUwXCdr5RPjwZYIDpOj8CHyjOmngWTgoKXPtZbg":3,"$fWcS-XDjuVud9MQYqqVjDR4MW-fscxNL5Lu2yYlTFRs4":32,"$f3Ft0rKFJHppdzE-vuveecxx1BUcg9iOlMLtyzf_MJDg":101},[4,8,12,16,20,24,28],{"title":5,"slug":6,"path":7},"About Microbeonline.com","about-microbeonline-com","\u002Fabout-microbeonline-com\u002F",{"title":9,"slug":10,"path":11},"About Me","about-me","\u002Fabout-microbeonline-com\u002Fabout-me\u002F",{"title":13,"slug":14,"path":15},"Advertise with Us","advertise-us","\u002Fadvertise-us\u002F",{"title":17,"slug":18,"path":19},"Privacy Policy","privacy-policy","\u002Fprivacy-policy\u002F",{"title":21,"slug":22,"path":23},"Abbreviations","abbreviations","\u002Fabbreviations\u002F",{"title":25,"slug":26,"path":27},"Microbes","microbes","\u002Fmicrobes\u002F",{"title":29,"slug":30,"path":31},"Books","recommended-books","\u002Frecommended-books\u002F",{"type":33,"data":34},"blog",{"slug":35,"title":36,"description":36,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":39,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"body":43,"faq":44,"tags":45,"related":48},"clostridium-perfringens-properties-diseases-and-diagnosis","Clostridium perfringens: Properties, Diseases, Diagnosis",null,"Acharya Tankeshwar","2020-05-03","2026-07-05",false,"bacteriology","*Clostridium perfringens* is a gram-positive, anaerobic, endospore-forming bacilli, often appear as **boxcar shaped**. It is mainly responsible for myonecrosis (gas gangrene), food poisoning, and gangrenous cholecystitis.\n\n![Common features of Clostridium perfringens - Common properties ofClostridium perfringens](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FClostridium-perfringens-common-features.jpg)Figure: Common properties of *Clostridium perfringens*\n\n## Properties\n\n1. **Gram staining:** Gram-variable straight rods with blunt ends occurring singly or in pairs; spores seldom seen but if present is large and central to subterminal, oval, and swell cell; large boxcar shape.\n2. It is capsulated, non-motile, gram-positive bacillus.\n3. It bears sub-terminal bulging spores but does not produce spores in tissues or in culture media (especially the gas gangrene strains).\n4. It is invasive as well as toxigenic.\n\n### Transmission\n\n*Clostridium perfringens* is a saprophyte in soil and also a commensal in the large intestine of human beings and animals. People get infected when the spores contaminate wounds from trauma.\n\n### Clinical manifestations\n\n*C. perfringens* infections are mostly polymicrobial involving other clostridia species. Various manifestations include:\n\n#### Clostridial Wound Infections\n\n1. **Simple wound contamination**: It involves the wound surface contamination, without invasion of underlying tissue, as occurs in the absence of devitalized tissue.\n2. **Crepitant cellulitis (anaerobic cellulitis)** is seen in diabetic patients. It involves the fascial plane with minimal toxin release, without muscle invasion.\n3. **Anaerobic myositis (gas gangrene)**: Clostridial myonecrosis (gas gangrene) is a serious infection that involves rapid invasion and **liquefactive necrosis of muscle with the gas formation** and clinical signs of toxicity. Pockets of gas are seen within the muscles and subcutaneous tissue and as the liquefaction of muscle continues a thin, blackish fluid exudes from the skin. The other clostridia most often involved in gas gangrene are *C. sordelli*, *C. septicum,* and occasionally *C. histolyticum*.\n\n#### Clostridial Enteric infection\n\n1. **Food poisoning:** Type A toxin-producing *C. perfringens* are a major cause of food-borne disease. *C. perfringens* food poisoning results from the consumption of raw or improperly contaminated meat and other food products containing a large number of (about 10^8 viable) organisms. Spores being heat resistant survive and germinate later when the food is cooled. Enterotoxin acts by forming pores in the intestinal mucosal membrane.\n2. **Necrotizing enteritis (enteritis necroticans, NEC)** is a life-threatening infection caused by Clostridium perfringens type C and type A and characterized by ischemic necrosis of the jejunum and gas in the tissue plane. The disease was called **“Darmbrand” (meaning “fire bowels”)** in Germany and **“Pig bel”** in Papua New Guinea.\n\nOther Clostridial infections are puerperal infections, anaerobic pleuropulmonary infections, and clostridial bacteremia. In rare cases, *C. perfringens* also causes meningitis, meningoencephalitis, and subdural empyema.\n\n## Laboratory diagnosis\n\nBased on the clinical diagnosis of gas gangrene, treatment should be started as early as possible. Laboratory diagnosis has a role only for (1) confirmation of the clinical diagnosis, (2) species identification.\n\n> Laboratories can diagnose C. perfringens food poisoning by detecting the bacterial toxin in feces using enzyme immunoassay or by quantitative anaerobic cultures. Serotyping of the isolates is done to determine if the same serotype of C. perfringens is present in the epidemiologically implicated outbreaks.\n\n#### Specimen\n\n1. Ideal specimens in the case of gas gangrene are **necrotic tissues,** muscle fragments, and **exudates** from deeper part of the wound where the infection appears to be more active. Other specimens depending on the type of infections include **suspected food** (to investigate food poisoning), **feces**, etc.\n2. Blood culture may be positive for *C. perfringens* and *C. septicum*. However, *C. perfringens* bacteremia can occur even in the absence of gas gangrene\n3. Swabs rubbed over the wound surface or soaked in exudates are not satisfactory.\n4. Specimens should be put into Robertson’s cooked meat broth and transported immediately to the laboratory.\n\n#### Direct Microscopy\n\nGram-stained smears of aspirated material from myonecrosis reveal a necrotic background with a **lack of inflammatory cells** and presence of gram-positive bacilli with a morphology resembling *C. perfringens* or other clostridia. Gram stained films provide clues about the species of clostridia present.\n\n![Boxcar shaped C. perfringens - Boxcar shapedC. perfringens](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FClostridium-perfringens-gram-staining.png)Figure: Boxcar shaped *C. perfringens*\n\n1. Thick, stubby, **boxcar-shaped**, gram-positive bacilli without spore are suggestive of *C. perfringens.* The cells of *C. perfringens* are usually 0.8 to 1.5 μm in diameter × 2 to 4 μm long and have blunt ends. They are often described as boxcar-shaped.\n2. Spore bearing gram-positive bacilli suggest other clostridia species\n\nCitron bodies (boat or leaf-shaped) pleomorphic irregularly stained bacilli with spores suggest *C.septicum.* Large rods with oval sub-terminal spores- suggest *C. novyi*\n\n#### Culture\n\n![Target hemolysis (Double zone hemolysis) - Target hemolysis (Double zone hemolysis)Image source: UPEI University](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FC.perfringens_plate_targethemolysis.jpg)Figure: Target hemolysis (Double zone hemolysis) Image source: UPEI University\n\nCulture plates should be incubated anaerobically at 37oC for 2 days. *Clostridium perfringens* do not produce spores in media routinely used in the clinical laboratory.\n\n**Blood agar:** After overnight incubation on blood agar, colonies are usually 1 to 3 mm in diameter, but may reach a diameter of 4 to 15 mm after prolonged incubation. Colonies are usually flat, somewhat rhizoid, and raised centrally. Some colonies tend to spread, but they do not swarm.\n\n**Target hemolysis (double zone hemolysis)**\n\nOn anaerobic blood agar, *C. perfringens* produces irregular colonies with an inner narrow zone of complete hemolysis (due to theta toxin), surrounded by a much wider zone of incomplete hemolysis (due to the alpha-toxin).\n\n![Lecithinase activity of C. perfringens in Egg Yolk Agar - Lecithinase activity ofC. perfringens in Egg Yolk Agar (Image source: Palaniappan Srinivasan)](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002Flecithinase-activity-c-perfringens.png)Figure: Lecithinase activity of *C. perfringens* in Egg Yolk Agar (Image source: Palaniappan Srinivasan)\n\n**Nagler’s reaction**\n\n*C. perfringens* produces an opalescence surrounding the streak line on egg yolk agar (EYA) or media containing 20% human serum due to **lecithinase activity of alpha toxin**. Opalescence can be inhibited by incorporating anti-alpha toxin to the medium. The test is also positive for other alpha toxin producing *Clostridium*; *C. bifermentans, C. baratti* and *C. sordellii*.\n\n**Reverse CAMP test**\n\n![Reverese CAMP test](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FReverse-CAMP-test-S-agalactiae-and-C-perfringens.jpg)Figure: Reverse CAMP test\n\nSuspected *C. perfringens isolate* is streaked over the center of anaerobe blood agar plate and *Streptococcus agalactiae* is streaked perpendicular to it. Presence of arrowhead of synergistic hemolysis with the tip of the arrow pointing from the *Streptococcus* toward the *C. perfringens*, is a positive reverse CAMP test.\n\n**Heat tolerance**\n\n*C. perfringens* can grow when [Robertson’s cooked meat (RCM)](\u002Frobertsons-cooked-meat-medium-principle-composition-procedure-and-uses\u002F) broth is incubated at 45°C for 4-6 hours. This differentiates it from other organisms in the specimen.\n\n**Litmus milk test**\n\nIn litmus milk, *C. perfringens* produces **“stormy clot reaction”** due to proteolysis of milk agar and fermentation of lactose producing acid and vigorous gas.\n\n![Stormy clot reactions by Clostridium perfringens](https:\u002F\u002Fassets.microbeonline.com\u002Fblogs\u002FStormy-clot-reaction.jpg)Figure: Stormy clot reactions by *Clostridium perfringens*\n\n**Other properties of *Clostridium perfringens***\n\n1. Non-motile\n2. Catalase negative\n3. No growth on chocolate agar in 5% CO2\n\n#### References and further readings\n\n- Tille, P. (2017). *Bailey & Scott’s Diagnostic Microbiology* (14 edition). Mosby.\n- Procop, G. W., & Koneman, E. W. (2016). [Koneman’s Color Atlas and Textbook of Diagnostic Microbiology](https:\u002F\u002Famzn.to\u002F2vRkUvk)(Seventh, International edition). Lippincott Williams and Wilkins.",[],[46,47],"anaerobic-bacteriology","gram-positive-rods",[49,55,61,71,77,83,89,95],{"slug":50,"title":51,"description":51,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":52,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":53,"tags":54},"clostridium-tetani-properties-pathogenesis-diagnosis","Clostridium tetani: Properties, Pathogenesis, Lab Diagnosis","2020-05-02",[],[47,46],{"slug":56,"title":57,"description":57,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":58,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":59,"tags":60},"toxins-clostridium-perfringens-roles","Toxins of Clostridium perfringens and their roles","2020-04-06",[],[46,47],{"slug":62,"title":63,"description":64,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":65,"lastUpdatedDate":66,"draft":41,"category":67,"image":37,"faq":68,"tags":69},"robertsons-cooked-meat-medium-principle-composition-procedure-and-uses","Robertson's Cooked Meat (RCM) Medium: Principle, Composition, Uses, and Interpretation","Robertson's cooked meat medium cultivates and enriches anaerobes — especially Clostridium species — using meat particles as natural reducing agents. Learn the principle, preparation, how to interpret saccharolytic vs proteolytic reactions, and how it compares to thioglycollate broth.","2016-11-29","2026-07-06","culture-media",[],[46,47,70],"anaerobic-culture-techniques",{"slug":72,"title":73,"description":73,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":74,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":75,"tags":76},"clostridium-difficile-characteristics-disease-laboratory-diagnosis","Clostridioides difficile: Characteristics, Disease, Lab Diagnosis","2015-11-30",[],[47,46],{"slug":78,"title":79,"description":79,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":80,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":81,"tags":82},"bacillus-cereus","Bacillus cereus: Morphology, Disease, Biochemical Tests","2021-05-31",[],[47],{"slug":84,"title":85,"description":85,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":86,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":87,"tags":88},"clostridium-botulinum-properties-pathogenesis-diagnosis","Clostridium botulinum: Properties, Pathogenesis, Lab Diagnosis","2020-05-01",[],[47],{"slug":90,"title":91,"description":91,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":92,"lastUpdatedDate":40,"draft":41,"category":42,"image":37,"faq":93,"tags":94},"bacillus-anthracis-properties-pathogenesis-diagnosis","Bacillus anthracis: Properties, Pathogenesis, Lab Diagnosis","2020-04-21",[],[47],{"slug":96,"title":97,"description":97,"seoTitle":37,"seoDescription":37,"author":38,"createdDate":98,"lastUpdatedDate":66,"draft":41,"category":42,"image":37,"faq":99,"tags":100},"gaspak-anaerobic-system","GasPak Anaerobic System: Principle, Application","2020-03-28",[],[46,70],[102,108,115,120,124,128,133,138,142,146],{"slug":103,"name":38,"description":104,"image":105,"body":106,"postCount":107},"acharya-tankeshwar","Editor-in-chief","https:\u002F\u002Fassets.microbeonline.com\u002Fauthors\u002Ftankeshwar-acharya-author-microbeonline.jpg","***Tankeshwar Acharya, MSc (Medical Microbiology)***\n\n*Tankeshwar Acharya is an Assistant Professor in the Department of Microbiology at Patan Academy of Health Sciences (PAHS), Nepal, where he has been teaching and practicing clinical microbiology for over 14 years. He is the founder of Microbe Online, one of the leading free microbiology education resources on the web, covering bacteriology, mycology, parasitology, immunology, and clinical laboratory diagnostics written from direct experience in both the classroom and the diagnostic laboratory.*",433,{"slug":109,"name":110,"description":111,"image":112,"body":113,"postCount":114},"ashma-shrestha","Ashma Shrestha","SEO Copywriter and Science Communicator\nKathmandu, Nepal","https:\u002F\u002Fassets.microbeonline.com\u002Fauthors\u002Fashma-shrestha.png","Ashma Shrestha holds a Master of Science in Medical Microbiology from the Institute of Science and Technology (IOST), Tribhuvan University, Nepal, where she developed a strong foundation in virology, molecular biology, and diagnostic microbiology.\n\nShe now works as an SEO Copywriter at Resolution Digital, where she combines her scientific training with research-driven content strategy. She is certified in Google Analytics and Google Business Profile (GBP), and brings a data-informed approach to science communication writing content that is not only accurate but structured to reach and serve the students who need it most.\n\nAt microbeonline, Ashma contributes articles primarily in virology and molecular biology, areas she finds most compelling for their mechanistic depth and their growing clinical relevance. Her writing reflects the same standard the site is built on: factual rigor, clear explanation of the *why* behind microbiology concepts, and content that helps students move from memorization to genuine understanding.\n\nShe is passionate about making complex microbiological concepts accessible without sacrificing accuracy; a skill that sits at the intersection of her scientific training and her professional work in content and SEO.",81,{"slug":116,"name":117,"description":118,"image":37,"body":37,"postCount":119},"sushmita-baniya","Sushmita Baniya","Author \u002F Contributor",32,{"slug":121,"name":122,"description":118,"image":37,"body":37,"postCount":123},"samikshya-acharya","Samikshya Acharya",20,{"slug":125,"name":126,"description":118,"image":37,"body":37,"postCount":127},"alisha-tripathi","Alisha Tripathi",6,{"slug":129,"name":130,"description":131,"image":37,"body":37,"postCount":132},"aastha-shrestha","Aastha Shrestha"," Author \u002F Contributor",10,{"slug":134,"name":135,"description":136,"image":37,"body":37,"postCount":137},"guest-author","Guest Author","Guest Author \u002F Contributor",2,{"slug":139,"name":140,"description":118,"image":37,"body":37,"postCount":141},"srijana-khanal","Srijana Khanal",18,{"slug":143,"name":144,"description":136,"image":37,"body":37,"postCount":145},"dr-poonam-acharya","Dr. Poonam Acharya",1,{"slug":147,"name":148,"description":118,"image":37,"body":149,"postCount":150},"nisha-rijal","Nisha Rijal","**Nisha Rijal** is a microbiologist and quality assurance specialist. She served for nearly 12 years as a microbiologist at the National Public Health Laboratory (NPHL), Nepal's national reference laboratory, and continues to work as a consultant microbiologist in international public health organization. ",51]