63 year old alcoholic taken to the er w/gangrene in both feet;He is stuporous;had a siezure during evening of transfer and was treated with phnytoin&bartituates;by nighttime he was noted to have opisthotonic posturing;developed increasing rigor,resp.distress and unresponsiveness;70/30mm Hg; HR110bpm,resp.rate40/min;rectal temp41.7 C;marked trismus;The neck was stiff and hyper extended; nectrotic blackened areas over both feet;several draining ulcers on heels and toes; neurologically the patient responded to deep pain w/a grimace. After specific therapy & supportive care was initiated the patient ultimately recovered. What is the etiology of infection?; What virulence factor produced by etiologic agent of his infection was responsible for his trismus?;How did the patient become infected with this organism?;what was the role of his gangrenous feet in the development of this infection?;What is the specific therapy used to reat this infection?;How might this infection have been prevented? This sounds like tetanus. Pretty classic description especially with the spasms and the lower extremity wounds. Such a shame since its so easily preventable with vaccinations, but you have to remember the booster shots every 5-10 years.
Check out Emedicine.com as it is a nice free online medical text. If you have access to MD Consult that is another good source. With these resources, you should be able to figure out the answers to your questions.
http://www.emedicine.com/emerg/topic574....
http://www.emedicine.com/med/topic2254.h... | 