Question A: The patient probably has gangrene. The onset of gas gangrene is sudden, appearing anywhere from 12 to 48 hours after the initial injury to the tissue. As the bacteria grow, they ferment and produce hydrogen gas, which causes breaks in the tissue. Movement of the affected area causes snap, crackle, and popping sounds.
Question B: There is also a foul smell associated with the tissue destruction, making it obvious that infection has set in. The infection is accompanied by a high fever, massive tissue destruction, shock, and blackened skin. If not treated quickly, a gas gangrene infection is lethal. However, the absence of the odor is confounding. Sampling the exudate and testing it for Clostridium perfringens is required for a definitive diagnosis.
Question C: Because the organism can sporulate, long-term treatment is required to remove all newly vegetating germs.
Question A: The patient probably has acne. Acne is the most common skin infection in humans, affecting 17 million people in the United States alone, with 85% being teenagers. Comedonal acne results from inflammation of the hair follicles of the face and the associated sebaceous glands, which become plugged by a mixture of shedding skin cells and sebum. As the sebum backs up and accumulates, whiteheads, called comedones, appear on the skin. If the blockage protrudes through the skin, blackheads, called comedones, appear on the skin. He could also have inflammatory acne, which is caused by the bacterium Propionibacterium acnes.
Question B: No. All types of acne can usually be effectively treated with topical drying agents.
Question C: The biggest problem about unnecessary antibiotic use is the development of antibiotic resistance.