TETANUS AND GAS GANGRENE Flashcards
(18 cards)
What is Tetanus caused by?
Tetanus is caused by the neurotoxin of Clostridium tetani
Tetanus leads to nervous irritability and tetanic muscular contractions.
What type of organism is Clostridium tetani?
Clostridium tetani is a gram positive anaerobic bacillus with a terminal spore
It has a characteristic drum-stick appearance.
How does Clostridium tetani infect a host?
It enters and flourishes in hypoxic wounds contaminated with soil or faeces
Tetanus-prone wounds are usually puncture wounds or have devitalized tissue.
What is Tetanus neonatorum?
Tetanus neonatorum arises from infection of the umbilical stump by contaminated dressings or powders.
What happens when the toxin of Clostridium tetani reaches the nervous system?
The toxin is fixed by the motor cells and cannot be detected in the blood or CSF
Tetanus antitoxin can neutralize the toxin before it gets fixed.
What are the first symptoms of Tetanus?
Pain and tingling in the area of injury, limitation of movements of the jaw (lock jaw), spasm of facial muscles
Other symptoms include stiffness of the neck and difficulty in swallowing.
What is the incubation period for non-immunized individuals with Tetanus?
The incubation period is short and varies from 3 to 21 days.
What is the mortality rate of established Tetanus with respiratory insufficiency?
The death rate is 30-60%.
What is the primary prevention method for Tetanus?
Every child should be actively immunized with tetanus toxoid, starting with routine childhood immunization DPT vaccine
Booster injections are required every 7-10 years.
What is the initial treatment for established cases of Tetanus?
Neutralize toxin with TIG (Tetanus Immune Globulin)
The dose is 3000-6000 units intramuscularly.
What is Gas gangrene associated with?
Gas gangrene is associated with gas formation and profound toxaemia due to infection by Clostridium perfringens and other Clostridia species.
What are predisposing factors for Gas gangrene?
- Lacerated wounds involving bulky muscles
- Presence of foreign bodies or devitalized tissues
- Ischaemia of the muscles
- May follow above knee amputation, especially in elderly persons.
What is the incubation period for Gas gangrene?
The incubation period varies from a few hours to a few days.
What investigations are used for diagnosing Gas gangrene?
- C/S from the discharge and anaerobic culture
- Lecithinase test
- Plain x-ray shows gas in the tissues.
What is the most important step in the treatment of Gas gangrene?
Wound management, which includes excising all dead tissues under general anaesthesia.
What is the mortality rate for Gas gangrene?
The current death rate is about 20%.
What is hyperbaric oxygenation used for in the treatment of Gas gangrene?
Hyperbaric oxygen inhibits bacterial invasion and the production of alpha toxin
It is given for 1-2 hours and repeated every 6-12 hours.
What is myonecrosis?
Myonecrosis refers to the necrosis of muscle tissue caused by clostridial infection.
