Nokea
4 days after a patient received a gunshot wound of the middle third of the thigh soft tissues his condition suddenly began deteriorating. There are complaints of bursting pain in the wound; pain increases during the last 12 hours. Edema of skin and hypodermic tissue quickly grows. Body temperature is 38,2oC, heart rate is 102/min. The wound edges gape, are dull in color; the muscles, viable as of day before, now protrude into the wound, look boiled, are dull in color, have dirty-grey coating and fall apart when being held with forceps. What infection has developed in the wound?
Correct Answer: A
Rationale: The correct answer is A: Anaerobic infection. The sudden deterioration, bursting pain, edema, foul appearance of wound, and presence of gas are indicative of gas gangrene caused by anaerobic bacteria like Clostridium perfringens. These bacteria thrive in low oxygen environments, such as deep wound tissues. The symptoms align with the classic presentation of gas gangrene, necessitating immediate surgical intervention.
Choice B: Aerobic gram-negative, is incorrect because anaerobic bacteria, not aerobic gram-negative bacteria, are responsible for gas gangrene.
Choice C: Putrid, is incorrect as it is a general term referring to foul-smelling decay and does not specify the type of infection.
Choice D: Aerobic gram-positive, is incorrect as gas gangrene is typically caused by anaerobic bacteria, not aerobic gram-positive bacteria.