NECROTIZING FASCIITIS

Necrotizing fasciitis is a relatively rare bacterial infection of the inner layers of skin and subcutaneous tissues. The disease is characterized by the rapid spread of bacteria along the fascial plane causing significant tissue damage. There are 2 types of Necrotizing Fasciitis, one is caused by multiple microbes (Type 1) and the other is caused by a single microbe (Type 2.) Since 2001 the leading monomicrobial cause of the disease has been MRSA. Prior to that, the most common culprit was Strep A.

The infection begins at a site of trauma. The trauma can be major such as a surgical cut or as minor as a paper cut. Once the bacteria is introduced to the wound, it rapidly multiplies and makes its way throughout the underlying tissues. The first symptoms of NF include pain at the trauma site (often more intense than the wound warrants) followed by swelling around the point of introduction. As the bacteria multiplies and releases toxins, the patient will begin to experience fever and vomiting. If the wound is shallow there will be apparent swelling, but if the would is deep the infection can progress to fever before outward signs of the infection appear at the site of the wound. The toxins from the bacteria actually kill the tissue that they come into contact with, causing it to begin to rot.

Mortality rates from SF are around 73%. Treatment includes antibiotics, but if the bacteria is unresponsive to treatment, surgery might be required to preserve unaffected tissue from the spread of the bacteria (amputation.)

Since this sick is so painful and spreads so rapidly through the body causing significant mortality levels, I rate it a

5 on my "lethality scale" (1-10)
and a 6 on my "disturbing scale" (1-10)

TETANUS

Tetanus is a bacterial infection caused by the microbe Clostridium Tetani. Clostridium Tetani releases a neurotoxin called tetanospasmin which causes the scheletal muscle fibers in the human body to contract uncontrollably. The Tetanus bacteria is most often introduced to the body via a cut or puncture wound, but there are also cases of neonatal tetanus, caused by nonsterile removal of the umbilicus from a non-immune infant. In modernized countries, infants are typically born with temporary immunity to tetanus because mothers who are up to date on their tetanus vaccines will automatically pass their immunity to their offspring.

Everyone is familiar with the idea that if you step on a rusty nail, you should get a tetanus shot, but tetanus infections have little to do with rust. Rather, any puncture or cut from a non-sterile object (such as a dirty needle) or an animal bite or scratch could introduce tetanus if the bacteria is present. Rust might increase the likelihood that the bacteria is present on the object because it forms a rough surface to which the bacteria can easily stick.

Symptoms of Tetanus usually begin within 3-21 days. Like Rabies, the disease takes longer to manifest if the point of introduction is located far away from the Central Nervous System. The first symptoms of General Tetanus include tightness in the jaw (lockjaw) and facial spasms, which cause a characteristic grin called risus sardonicus. These symptoms progress into neck stiffness, difficulty swallowing and pectoral and calf rigidity. Victims also experience fevers, sweating, high blood pressure and rapid heart rate. People in the throws of full blown tetanus will have instense full-body spasms refered to as Opisthotonus, in which the body involuntarily forms an arch.

The most effective way to avoid Tetanus is through vaccination, and the first form of treatment for a suspected infection is prophylactic vaccination. However, once the disease is symptomatic, treatment consists of life preserving measures such as assisted breathing, intravenous valium and high calorie tube feeding.

Mortality from tetanus is currently 11%.

Because of it's limited mortality but horrible manifestations I give Tetanus a
4 on my "lethality scale" (1-10)
and a 6 on my "disturbing scale" (1-10)