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It is an Aerobic, Gram-positive rod
19%
781/4180
It is an Anaerobic, Gram-positive coccus
22%
917/4180
It is an Anaerobic, Gram-negative rod
775/4180
It is Catalase positive
4%
183/4180
It may cause botulism
36%
1498/4180
Select Answer to see Preferred Response
The organism being covered with penicillin is Clostridia spp. Clostridium botulinum is a Gram Positive Bacilli that is the cause of botulism. Clostridia spp, is a Gram-positive, obligate anaerobic spore-forming rod that is found in soil and gut flora. It produces gas by the fermentation of glucose and may cause gas gangrene. Common bacteria of this genus are C. perfringens (most common), C. tetani (causes tetanus), C. difficile, and C. botulinum (causes botulism). If wounds are grossly contaminated with soil, penicillin is given to cover against Clostridia. Decoster et al. performed a review of traumatic foot wounds. They report that lawnmower injuries to the foot are relatively common. IV antibiotic therapy should be initiated with a broad-spectrum cephalosporin and an aminoglycoside to provide coverage against Gram-negative organisms. Penicillin should be given to protect against Clostridial infection. They conclude that irrigation and debridement is indicated initially followed by packing of open wounds. Repeat debridements are necessary as nonviable tissue demarcates. If major reconstructive procedures are necessary, they should be delayed as they have a high rate of failure if performed too soon. Cross et al. wrote a review on treatment principles in the management of open fractures and they note that in open fractures with soil contamination, additional coverage should be added for anaerobic bacteria, typically Clostridia. Another member of the genus Clostridia is C. tetani, the causative agent of tetanus. Vaccine status for tetanus must also be assessed in these situations as well. Illustration A is a radiograph demonstrating soft tissue swelling and subcutaneous emphysema, consistent with gas gangrene. Illustration B is a clinical photograph of gas gangrene evidenced by edema, discoloration, ecchymosis, and hemorrhagic bullae. Illustration C is a pathology slide of C. perfringens, a Gram-positive rod. Incorrect Answers: Answers 1, 2, 3: Clostridia are Gram-positive, obligate anaerobes. Answer 4: Clostridia are catalase negative.
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