It's International Women's Day today: all the women in the hospital are greeted with a rose and, if they're lucky, a lollipop. I don't recall anyone ever celebrating Women's Day in the UK, but then roses are far more expensive there.
Twitch. In the ICU, one woman is not spending Women's Day as she might have hoped. A few days ago, (twitch), she went to the dentist to have a cavity treated. Somewhere along the way, she became infected with Clostridium tetani, which, as its name suggests, is the bacterium responsible for causing tetanus. Twitch. Painful spasms in the muscles of her jaw brought her to the hospital. Now, after a hefty dose of sedation and muscle relaxants, she is beginning a long and dangerous hospital stay (twitch). She is at very high risk of developing a respiratory infection which, given the frightening rates of antibiotic resistance here, would surely be a death sentence. Despite the doctors' best efforts (twitch), uncontrollable spasms still shake her body every few minutes. You cannot help but look on, waiting for the next one. Twitch. If it wasn't for the sedatives, she would be in agony.
The Clostridium family is a nasty one, responsible as it is for tetanus, gas gangrene and botulism. C. tetani loves a dirty wound and, given the opportunity, will invade in a matter of days. It produces a toxin which specifically targets the central nervous system, impeding the normal mechanisms which regulate muscle contraction. The result is violent muscular spasms, typically starting with the masseters, leading to 'lock-jaw'. The expression risus sardonicus (sardonic smile) is still sometimes used to describe the snarl produced by the disease. (Interestingly, the word 'sardonic' apparently alludes to a Sardinian plant which, when eaten, would produce convulsive laughter and death - so much for herbal medicine). The other characteristic feature of tetanus, the arching of the back or opisthotonus, is more commonly seen in infants than in adults.
Fortunately, tetanus is very preventable. The vaccine probably confers ten years' protection, and it is thought that after three or four jabs there is life-long immunity. In Vietnam, 85% of the population is immunized; however that leaves nearly 13 million unprotected individuals. As the disease does not prevent subsequent re-infection, patients are always followed up with three jabs. Hopefully, with improving vaccine coverage, tetanus will become as rare in Vietnam as it is today in Europe, and patients such as this one will be able to celebrate Women's Day without all the twitching.
Twitch. In the ICU, one woman is not spending Women's Day as she might have hoped. A few days ago, (twitch), she went to the dentist to have a cavity treated. Somewhere along the way, she became infected with Clostridium tetani, which, as its name suggests, is the bacterium responsible for causing tetanus. Twitch. Painful spasms in the muscles of her jaw brought her to the hospital. Now, after a hefty dose of sedation and muscle relaxants, she is beginning a long and dangerous hospital stay (twitch). She is at very high risk of developing a respiratory infection which, given the frightening rates of antibiotic resistance here, would surely be a death sentence. Despite the doctors' best efforts (twitch), uncontrollable spasms still shake her body every few minutes. You cannot help but look on, waiting for the next one. Twitch. If it wasn't for the sedatives, she would be in agony.
The Clostridium family is a nasty one, responsible as it is for tetanus, gas gangrene and botulism. C. tetani loves a dirty wound and, given the opportunity, will invade in a matter of days. It produces a toxin which specifically targets the central nervous system, impeding the normal mechanisms which regulate muscle contraction. The result is violent muscular spasms, typically starting with the masseters, leading to 'lock-jaw'. The expression risus sardonicus (sardonic smile) is still sometimes used to describe the snarl produced by the disease. (Interestingly, the word 'sardonic' apparently alludes to a Sardinian plant which, when eaten, would produce convulsive laughter and death - so much for herbal medicine). The other characteristic feature of tetanus, the arching of the back or opisthotonus, is more commonly seen in infants than in adults.
Fortunately, tetanus is very preventable. The vaccine probably confers ten years' protection, and it is thought that after three or four jabs there is life-long immunity. In Vietnam, 85% of the population is immunized; however that leaves nearly 13 million unprotected individuals. As the disease does not prevent subsequent re-infection, patients are always followed up with three jabs. Hopefully, with improving vaccine coverage, tetanus will become as rare in Vietnam as it is today in Europe, and patients such as this one will be able to celebrate Women's Day without all the twitching.
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