Due to the multiplicity of answers on my last post, I should expound on tetanus some. I remember a case when I was in training in Macon. I dont remember if he survived, but that had to be the most painful thing I have ever seen! It is not just the jaw that locks, but every muscle in the body. He was on huge doses of valium iv and Morphine, and was still writhing in pain. He would go into opistotonus, a condition where the back muscles would spasm and draw him into an position like an archery bow. He could not eat or swallow or chew, and screamed constantly. The nail thing comes from the fact that nails rust more when exposed to the soil, and tenanus is transmitted from animal feces in the soil. So naturally, the nail you get tetanus from is most likely rusty, but the rust is not a factor in and of itself. A clean nail in a stockyard is just as likely to give you the disease. The location has to do with the concentration of animal feces present, thus you would have more feces per square yard in a stockyard than the other places. A barnyard would also be a good answer. Rusty barbed wire is also suspect for the same reason as a nail, and more likely to be around farm animals. Again, here the rust is not an independent factor. Now my patient did not suffer any broken bones, but if he had been an osteoporotic female, we would have had to call in the orthopedic surgeon. Remember that tetanus has a long incubation period, so just because it has been two weeks since your injury and it has healed, does not make you safe. It can begin as long as a month after the injury, with a few germs slowly growing in the healed wound. It is not the infection, but the toxin the germs produce that causes the problem. The most important thing besides the TDap vaccine is a complete and thorough cleaning of the wound to remove any foreign material in there that may harbor the organism. So scrub all the gunk out of your cuts asap! One more question: In the TDap vaccine we give now, what does the p stand for and why are we giving this now, when we used to just give the DT. Part I: a. pneumonia b. pertussis c. polio d. Pickwickian syndrome e. parkinsons disease part II A. because polio has made a comeback in California B. The mortality rate for pneumonia is still as high now as in 1800. C. Pertussis has made a comeback and infects babies D. Pickwickian syndrome is epidemic in this country. E. Parkinsons has no cure and must be immunized for.
Posted on: Wed, 12 Mar 2014 04:30:12 +0000
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