George, while working in the bar, ran a rusty nail through the bottom of his foot. What infectious disease should he be concerned about? Why is this disease usually associated with injuries from rusty nails? What are the signs and symptoms, diagnosis, and treatment for this disease?

Answer:

1) George should be concerned about TETANUS which is caused by a bacteria named Clostridium tetani .

2) Actually, Tetanus has nothing to do with the rust itself. Clostridium tetani causes Tetanus and this bacteria dwells in places such as dust, feaces,soil and in most of our surroundings.

These bacteria can infect the body through open wounds( deep and penetrating). So it depends upon the nature of the wound rather than the objects causing it. When an object penetrates into the skin ,it builds a tunnel for bacteria to enter into the body which can cause tetanus.

In general, people say that any injury with rusty nail causes tetanus because a nail causes deep penetrating wounds and rust on the nail indicates that it was in a dirty environment but remember that environment might not be visibly dirty.

3) Tetanus :

Signs and symptoms :

• Stiffness and spasm of jaw muscles
• Neck muscles stifness
• Difficulty in swallowing
• Stiffness in abdominal muscles
• Painful body spasms
• Fever/ High B.P/sweating etc are also seen

This disease is also known as "LOCK JAW" and these symptoms are due to toxin produced by the bacteria affecting nervous system and causing painful spasms of muscles in the body( mainly jaw and neck muscles).

Diagnosis :

• Laboratory tests aren't helpful in diagnosing tetanus.

Doctor makes the diagnosis with :

• Physical examination
• Immunization history ( no H/o Tetanus vaccination or booster dose not taken)
• muscle spasm,stiffness and pain.

Treatment:

• Tetanus antitoxin should be given.
• Antibiotics to fight against bacteria
• Tetanus vaccine
• Sedatives to relieve muscle spasms
• Some other drugs depending upon the presenting symptoms of patient
• Patient will be kept on ventilator as sedatives can inhibit breathing.

After treatment, patient should be educated regarding proper vaccination and how to deal with open wounds.