About an hour later, Dr. Umphasea enters Mr. Gower’s cubicle in the ER holding a folder. Mr. Gower is asleep, so the doctor talks to his wife.
“The lab results are in and they confirm my initial suspicion from the tongue depressor test. Your husband is infected with Clostridium tetani, a bacterium that usually lives in the soil. The wound culture came back negative, but I am pretty sure that it entered his body through the incision made by the dentist while doing the root canal.”
The doctor continues, “The penicillin should clear up the bacteria. The nurse has cleaned up the wound and given him shots of antitoxin and a tetanus vaccine. We are going to keep him here for a few days before we release him. I will prescribe diazepam, which is a tranquilizer that will help relax the muscles. Do you have any children at home?”
Mrs. Gower answered, “Our grandchildren are supposed to come visit next month, over Easter, but we can cancel if necessary.”
“Well, let’s not do that right now. When he gets home, he will need an environment with dim lights, little noise, a constant temperature, and lots of bed rest. He will continue with diazepam, but you will have to be careful to follow the directions, because it is a highly addictive drug. We’ll probably give you some sedatives if he has trouble sleeping while he is here, but judging by his appearance right now, he probably won’t have any problems with sleeping.”
Mrs. Gower smiles.
The doctor continues, “The treatment may take a long time. I think we caught the infection early, but you will need to keep an eye open for signs of breathing difficulties and pneumonia.”
An action potential in a motor neuron produces a contraction of the muscle fibers it supplies. Tetanus toxin is thought to decrease inhibitory synaptic effectiveness, especially onto the motor neurons to the face and neck. As a result, the motor neurons produce more action potentials than usual and the muscles remain contracted over a long time period. One effect of tetanus infection is called lockjaw.
Originally published at http://www.sciencecases.org/chin/chin5.asp
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