A 23 year old male patient demonstrating severe face and arm muscle spasms was brought to the emergency department by his brother. The patient can hardly speak, so you try to get more information from the brother. You note that the patient has many tattoos, including a fresh one on his shoulder. The brother tells you that the patient just got that tattoo yesterday, and that the tattoo parlor was “sketchy.” You order blood tests, and when you get the results, it confirms your suspicion: this patient is infected with Clostridium tetani, a common bacterium found in soil that can be transmitted by using dirty needles. The patient was never vaccinated against this bacterium. Clostridium tetani produces a toxin that affects neurons and their ability to release neurotransmitters. The worried brother asks you to explain this patient’s condition.
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