Tetanus and Organism | Case Study
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Added on 2019-11-25
Tetanus and Organism | Case Study
Added on 2019-11-25
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This template must be used to answer the case study. (Please type your answers within the box underneath each question)Student name (LAST NAME first name):Student number:Campus:Tutorial session (time and room no.):Tutor’s name:1.Rationale for giving Mary a tetanus booster (Total: 5 marks)1.1What is the organism that causes tetanus and why is it of concern in this situation? Mary has suffered a rather deep cut while working in the garden and the wound mightbe contaminated with soil. Clostridium tetani, the bacterium that causes tetanus can occur in the soil in the form of endospores, it is a Gram-positive bacterium and can live anaerobically once it infects tissues. The bacterium causes tetanus due to the release of two protein toxins, tetanospasmin which is a neurotoxin and tetanolysin which is a hemolysin. Tetanus is a painful condition that causes muscle spasms and even prove to be fatal [ CITATION Imm17 \l 16393 ].1.2According to the guidelines in the “The Australian Immunisation Handbook” (Dept. of health, 2017) on administering a tetanus booster, discuss the rationale for giving Mary the tetanus boosterAccording to the Australian Immunisation Handbook, a person who reaches 50 years of age should be given a tetanus booster, if he or she has not received one during thepast 10 years. Mary is 50 years of age and therefore she should receive the booster. But her injury which has been exposed to garden soil makes the booster all the more necessary. Besides there have been cases where a booster within the last ten years has not been able to prevent tetanus in patients with seemingly minor injuries. So, it isnecessary that Mary receive one soon after the occurrence of the injury. It will increase the concentration of circulating antibodies and offer adequate protection from tetanus [ CITATION Imm17 \l 16393 ].2.Physiological basis of the three wound observations (Total: 10 marks) 2.1For each of the three wound observations indicate, and provide a rationale, as to whether it is a sign or a symptom.The three wound observations when Mary reported after 48 hours of the injury at the hospital were, hot and red edges of the wound, swelling in the tissue surrounding the injury and purulent and odorous discharge from the wound. Hot and red edges of the wound are a sign that an inflammatory process is underway, swelling around the wound is a sign that capillary exudate has collected in the tissue, while the associatedpain is a symptom. Purulent and odorous discharge is a symptom of bacterial infection in the wound.
2.2Discuss the physiological basis of the first observation.An acute inflammation occurs as soon as the injury occurs due to the release of compounds that cause the inflammation. These are prostaglandins, histamines, complement, leukotrienes, kinins, chemotactic factors, nitric oxide, platelet activating factors, cytokines and interferons. Many of these cause the arterioles to dilate and increase their permeability so that cells can extravasate and reach the injury site and kill the pathogens through phagocytosis. There is an increase in the flow of blood to the area due to vasodilation of arterioles, so the edges appear red. The temperature of the tissue surrounding the injury increases, this raises the metabolic rate of the cells, causing the edges to appear hot [ CITATION Mar14 \l 16393 ].2.3Discuss the physiological basis of the second observation.Swelling in the tissue surrounding the injury occurred due to collection of fluid that may have oozed out from the capillaries. The fluid that is rich in proteinaceous matter collects in the spaces around the tissues and is known in medical terminology as edema. The swelling is usually associated with pain. Occurrence of pain discourages the patient from moving the affected area and this helps during the process of healing[ CITATION Mar14 \l 16393 ].2.4Discuss the physiological basis of the third observation.The wound produces a purulent exudate that has a malodour. This is a sign that the wound is infected. The fever is another symptom that points at the infection. Although Staphylococcus aureus lives on the skin as part of normal skin flora, once it infects the wound, it derives nutrition from the subcutaneous tissue and becomes pathogenic. It can be treated with appropriate antibiotic therapy. An infected wound is painful and does not heal unless the infectious bacterium is eliminated [ CITATION Lee16 \l 16393 ].3.Development and benefits of fever (Total: 5 marks).3.1How did Mary’s fever develop?Mary's fever developed due to the inflammatory response to the infected wound. The pathogenic bacteria release endotoxins that act as exogenous pyrogens and trigger the release of endogenous pyrogens from the inflamed tissue. The pyrogens include cytokines, tumor necrosis factor-α, interleukin-1, interleukin-6 and some interferons. The pyrogens elicit the release of three important chemicals that trigger the febrile response. These are prostaglandin E2, endothelin I and the corticotrophin-releasing factor. The effect of these factors onthe preoptic area of the anterior hypothalamus that is involved in thermoregulation, causes fever.The body begins to heat, the peripheral vessels constrict and loss of heat is conserved. The core body temperaturebegins to rise beyond the normal temperature of 37oC and fever occurs[ CITATION Cra15 \l 16393 ].3.2Discuss two ways in which fever is beneficial.
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