CASE 1

A 28 year old male fell from the roof of his home (in a remote area of Montana) onto a metal grounding rod (stuck in the ground), that partially penetrated his left calf. He controlled the bleeding after removal of the rod, but elected not to seek attention since his home was two hours from the closest health care facility. The following morning with shaking chills and leg pain. His leg was swollen and warm, with cloudy fluid draining from a very darkened wound site. He had a friend drive him to the hospital, where he was found to be stuporous, but able to answer questions. Physical Exam: T= 35°C, P=120, RR=24, BP=90/54. The important physical findings were limited to the left leg, tense edema to mid thigh, marked tenderness with blanching of skin and tense bullae (fluid collections) around wound site. The skin also contained dark areas of apparent necrosis, with serosanguinous, dirty, foul smelling discharge from the wound. Palpation of skin revealed crepitus. Gram stain of discharge revealed rare WBC and many Gram positive rods.

1. Describe succinctly the disease Gas gangrene

2.Describe the offending organism of this case, its morphologic, cultural characteristics  and their normal habitat.

3. What kinds of hosts are susceptible?

4. How do these organisms gain access to humans?

5. How do they invade and spread in humans?

6. What defenses humans have against these organisms?

7. How do these organisms able to overcome human defenses?

8. What is the end result of this battle between organisms and humans?

9. How do you diagnose this infection?

10. What will be your therapeutic strategy?

11. How can you prevent it from spreading to others? Prevent its occurrence?

12. What are other clinical infections with these organisms?

13. What are the disease associated with other species of Clostridium?