HS1202: A 17-year-old Was Brought to the Accident and Emergency unit With Severe Muscle Spasms: Anatomy and Physiology, Singapore

Type:

Clostridium tetani
Gram-negative bacilli.
Rod-shaped bacteria
Obligate anaerobe

Case scenario:

A 17-year-old was brought to the accident and emergency unit with severe muscle spasms. Noted history of accidental injury and contact with soil 1 week before. A patient has not taken any Tetanus Toxoid vaccine in the past. The patient was having difficulty in breathing and noted muscle twitching’s in the face and difficulty in the closing the mouth.

Chain of infection:
Pathogen: Clostridium tetani
Reservoir: soil/ rusted particle
Portal of exit: soil/ rusted particle
Methods of transmission: skin, injury to the skin
Portal of entry: enters by a puncture wound

Pathogenicity in the new host: tetanus exists as spore in the soil. Once they enter the skin, they release toxins. Exotoxins attack the nervous system and cause muscle spasms → which can even cause death due to diaphragm paralysis.

Ways to break the chain of infection:

Washing and cleaning the skin wound after contact with soil/ rusted material.

Taking tetanus vaccine
Keeping wound clean
Good hand hygiene.

Disinfection and Sterilization methods:
List the methods which are applicable for this microorganism.
Autoclave

Any special mention: (carrier, flora, opportunistic pathogen)

It forms spores and is lives in the soil for many years, once it gets a suitable
environment, the spore becomes bacteria again.

Tetanus can be never eradicated.

In Tetanus patients, the risorius muscle is contracted to give them a grin, called risus sardonicus.

2. Skin topic: stratum Germinativum

This is the fifth layer of the skin – the epidermis.

This is also called stratum basale

There are two important cells in this layer

• Melanocytes – produces melanin, gives colour to the skin
• Stem cells – regeneration of skin cells
• Receptor cells