外科手术的感染PPT.ppt

Acquired Immunodeficiency Syndrome (AIDS) AIDS continued to increase as a result of unsafe sexual practices and in recipients of blood products. Differentiation : Tardive Dystonia Strychnine poisoning Dental infections Local infections Hysteria Neoplasms Encephalitis Complications Spasm of the vocal cords and/or spasms of the respiratory muscles that cause interference with breathing . Fractures of the spine or long bones Hypertension Abnormal heartbeats Coma Generalized infection Pneumonia Death Treatment Passive immunization with human tetanus immune globulin (TAT) shortens the course of tetanus and may lessen its severity. A dose of 1500 U appears as effective as larger doses. . The goals of pharmacotherapy are to prevent complications and to reduce morbidity. . Gas gangrene Conception : A clostridial infection typically involves underlying muscle, is also termed clostridial myonecrosis . . An anaerobic, gram-positive, spore-forming bacillus of the genus Clostridium causes gas gangrene. The most common organisms are C. perfringens, C. novyi, and C. septicum . . Etiology and pathophysiology These organisms are in soil, dust, and isolated from the GI tract and the female genital tract. Clostridia are obligate anaerobes, but some species are relatively aerotolerant. Other bacteria capable of producing gas, and nonclostridial organisms have been isolated in 60-85% cases of gas gangrene. . C perfringens produces at least 20 exotoxins. The important exotoxins and their biologic effects are as follows: Alpha toxin - Lethal,* lecithinase, necrotizing, hemolytic, cardiotoxic Beta toxin - Lethal,* necrotizing Epsilon toxin - Lethal,* permease Iota toxin - Lethal,* necrotizing Delta toxin - Lethal,* hemolysin Phi toxin - Hemolysin, cytolysin