Question

A. What is the probable diagnosis of this patient? Describe the phase of the disease B. what is the likely microorganism involved? C. How did he acquire the disease? D. Stan's partner, Tracy is in her second trimester of pregnancy. Should we be concerned about the health of the fetus? Why? E. Who should be screened for STDs based on the epidemiology of the case? A 58-year old lawyer presents in the emergency room with a headache, irritability. generalized muscle pain and uncontrollable back spasms. He has become very restless and worried because he has had the back spasms all through his court case that afternoon and they became extremely painful. 1. In his history, the lawyer states that he has a very busy practice. He is on medication for high blood pressure (beta blocker) and has mild asthma. He injured himself about 20 days earlier, puncturing his left arm with a nail from an old barn he is tearing The wound has produced moderate quantities of pus, but he has been keeping it clean. When asked he did not remember having any vaccine shots since he was a kid. The wound was sampled for microscopic examination and culture. The back appears to have very tight contractions and spasms. The patient is in apparent agonizing pain. a. What is your diagnosis here? b. What is the proper treatment of this problem? c. How could this have been prevented?

Answer 1

A. Based on the history of puncture in his left arm and spasm over his back it is a typical sign of tetanus, therefore the final diagnosis would be tetanus.

B. Proper treatmenft for tetanus would be to immediately administer a tetanus toxoid vaccination, starting antibiotics, and symptomatic treatment such as muscle relaxant for spasm, antipyretics in case of fever, other care would be to clean the affected the area.

C. This could have been prevented if the patient would have taken tetanus toxoid vaccination every 6 months, repoting or visiting physician as soon as the incident.