It can practically be eliminated by tetanus vaccine immunization if properly initiated and maintained antibiotic 1000mg order cheap goldamycin on line. Etiology: Clostridium tetani antibiotic resistance cdc order discount goldamycin line, a gram-positive rod found in soil and manure is the causative agent antibiotics for face rash order genuine goldamycin online. It require anaerobic environment for growth, invasion and elaboration of toxin, tetano-spasmin for its dramatic virulence. Clinical Features: - Can be latent with healed and forgotten wounds - Local or generalized weakness - Stiffness or cramping pain on the back, neck and abdomen - Difficult of chewing and swallowing - Tonic muscles spasms - Sardonic smile as evidence of onset of tonic spasm - Severe pain and opisothonus due to reflex convulsion of all muscles - Progressive difficulty of respiration - Fever, tachycardia, cyanosis - Respiratory failure and death due to repeated cyanotic convulsive attacks. Patients with grossly contaminated wounds and no or unclear history of immunization should receive an intramuscular antitoxin therapy. Gas Gangrene Gas gangrene is another clostridia associated with soft tissue infection (Clostridial myonecrosis). It is a rare but devastating infection characterized by muscle necrosis and systemic toxicity due to the elaboration and release of toxins. It usually follows wounding with trauma or surgery and requires factors contributing to tissue hypoxia like foreign bodies, vascular insufficiency or occurs as a complication of amputation. More than one species can be isolated or polymicrobial infection with other microorganisms can occur. A) Urinary tract infection after catheterization for Prostatectomy B) Abscess formation following injection on the thigh C) Wound abscess following excision of big lipoma on the back D) Lung atelectasis following intubation for laparotomy E) None of the above 2. A) Virulent microorganism B) A tissue of decreased or no blood supply C) A decrease in the immune response of a patient D) All of the above E) None of the above 3. A) Fever B) Loss of function of body part C) Local hyperemia D) Tachycardia E) All of the above 5. The correct way of managing a patient with an abscess is A) Start with effective antibiotics and send home B) Drainage and no antibiotics if no systemic signs C) Apply local ointments for aiding the abscess to burst D) Give effective antibiotics and analgesics E) All except B 7. In a patient with gas gangrene A) Little circulatory support is needed B) Surgical removal of gangrenous tissue is the primary management C) Penicillin is the preferred antibiotic D) B and C are correct E) Systemic signs are not commonly seen 74 Key to the Review Questions 1. Introduction Trauma is one of the leading causes of mortality, morbidity and disability worldwide. In developing countries, the magnitude of the problem has been increasing consuming more and more of the meager health resources of these nations. Moreover, trauma mostly affects people in their productive years of life, hence the high economic and social burden to society. The causes of trauma are various and their relative incidence varies in different populations. Immediate death (50%) Occur in the first few minutes after the accident Are due to extensive and lethal injuries to the brain, heart & major blood vessels 2. Early deaths (30%) Occur in the first few hours Are due to the collections and bleedings in the chest and abdomen, extensive fractures and increased intracranial pressure Early resuscitation, diagnosis and appropriate management can prevent these deaths. Types of Trauma: Trauma can be classified according to the: I- Cause: Homicidal injuries Road traffic accident and falls Industrial accidents, burn, etc. I- The primary survey and resuscitation This part of management comprises a quick evaluation of the patient to detect immediately life threatening situations and institution of measures to correct them. It may be compromised by pneumothorax, hemothorax or multiple rib fractures causing flail chest. Look for external hemorrhage and arrest it by pressure, bandaging or tourniquet if the other methods fail. Tachycardia, hypotension, pallor may mean bleeding into the body cavities or from an obvious external wound. E- Expose (undress) the patient fully for examination not to miss serious injuries.
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