Foaming liver is seen in:
a. Foaming liver is a feature seen in gas gangrene , as this gas producing ability gives rise to gas formation in the cavitatory lesion of the liver.
b. Gas gangrene is characterized by rapid and extensive necrosis of muscle accompanied by gas formation and systemic toxicity and occurs when bacteria invade healthy muscle from adjacent traumatized muscle or soft tissue.
c. The infection originates in a wound contaminated with clostridia. Although >30% of deep wounds are infected with clostridia, the incidence of clostridial myonecrosis is quite low.
d. These infections occur in both military and civilian settings. An essential factor in the genesis of gas gangrene appears to be trauma, particularly involving deep muscle laceration.
e. The entity of clostridial myonecrosis is relatively uncommon after simple, through-and-through bullet wounds without shattering of bone and is relatively common after shrapnel fragmentation wounds, particularly when deep muscle is involved.
f. The trauma need not be severe; however, the wound must be deep, necrotic, and without communication to the surface.
g. The skin is tense, white, often marbled with blue, and cooler than normal. The symptoms progress rapidly; swelling, edema, and toxemia increase, and a profuse serous discharge, which may have a peculiar sweetish smell, appears.
h. Gram's staining of the wound exudate shows many gram-positive rods with relatively few inflammatory cells.