This guide will explain almost all of the additions and changes from NT Infections. There will not be exact figures on this guide. If you want the numbers, look at the spaghetti code in the files.

NT Infections is an addon to Neurotrauma by Ma'am (though I recommend using the maintenance version instead). Please install Neurotrauma and place NT Infections below it in the mod list for it to work. If NT Surgery Plus is installed, place NT Infections below it as well.

NT Infections adds several new infections that a person can develop after injuries/surgery. In base Neurotrauma, wounds would become infected, and at a certain point those infected wounds would lead to sepsis, which could be easily treated by broad-spectrum antibiotics. With NT Infections, infected wounds will lead to an infection, and that infection may enter the blood and lead to sepsis. Infections will need to be treated with the proper antibiotics.

Infections are acquired from infected wounds, which can come from burns, lacerations, gunshot wounds, etc. Should a wound not be cleaned or dressed in a timely manner, a player may acquire an infection. Infections may also be acquired surgically if NT Surgery Plus is installed.

Initial infections will first be localized to a specific limb or area, and that limb or area may present with different symptoms as the infection progresses. The most obvious sign of infection is inflammation, followed by cellulitis. An abscess or pus drainage may also occur during an infection as well. Abscesses will form on a limb if it is infected and there are no injuries on that limb (or surgical cuts). Pus drainage will appear if there is an infection along with an open wound or sutures.



Limb infections may vary from moderate to severe. Should an infection not be treated in time, the infection may spread into the bloodstream and cause sepsis. Infections may also cause other various diseases that may complicate recovery.

• Streptococcal Infection
  
• Staphylococcal Infection
  
• MRSA Infection
  
• Pseudomonas Infection
  
• Provobacter Infection

Caused by gram-positive bacteria from the genus streptococcus. These germs were first brought over by Earthling colonizers during the colonization of Europa. Streptococcus can cause a range of diseases in humans such as skin, respiratory, or blood infections. Strep infections are quite common.

Another germ from Earth. Caused by the gram-positive bacteria, staphylococcus aureus. These infections are the most commonly encountered when dealing with injuries. Staph is known to cause various skin and blood infections.

A strain of staphylococcus aureus that has gained resistance to several different antibiotics due to extensive antibiotic usage. It is impervious to many penicillin-type antibiotics. MRSA infections are fairly common.

Caused by gram-negative bacteria from the genus pseudomonas. These germs are naturally resistant to many different antibiotics, making it difficult to treat. Can cause various skin and blood infections. Pseudomonas infections are fairly uncommon.

Caused by gram-negative bacteria from the genus provobacter. These germs are native to the Europa biosphere and can be found just about anywhere in the Europan sea. They are known to cause several diseases in humans. Provobacter infections are quite common.

The immune system is your only defense against any infection. Should a person's immunity be compromised during an infection, this may increase the risk of mortality. Possible causes for immunodeficiency include radiation sickness, immunosuppressants, burns, etc.

When a limb is infected, the immune system will begin to respond to the infection by building up a defense. The speed at which this defense increases is dependent on the person's immunity level. As the immune defense builds up, it will slow down the infection until it overpowers it, at which point the infection will slowly clear up. Not every infection will be resolved by the immune system. Some infections may be very severe, requiring the use of antibiotics to fight against them.

When an infection enters the blood, the immune system will no longer be enough to fight against the infection, and antibiotics are required. That is to say, antibiotics are only one part of the defense against blood infections. A healthy immune system is still required to fight off blood infections. The same general process applies for blood infections. When an infection enters the blood, the immune system will have a systemic reaction to the blood infection and begin a defense buildup.

Antibiotics are the primary method of treating bacterial infections. Certain infections will respond better to specific antibiotics, so care must be taken in choosing which antibiotic to use as treatment. All antibiotics have the side effect of nephrotoxicity, and certain antibiotics will lead to more kidney damage than others. Giving antibiotics without the proper skill will lead to greater kidney damage.

Antibiotics primarily work with the immune system. This means that antibiotics themselves do not fight against the infection, but rather slow it down enough to provide the immune system with an easier time dealing with it. Stacking different antibiotics provides greater effect but with diminishing returns. Sometimes infections can be beat without antibiotics, provided the severity of the infection is low and the immune system is healthy.

Broad-spectrum antibiotics (vanilla antibiotics) still exist, though they do not have much of an effect on these infections and act more as a precursor ingredient to the more specialized antibiotics.

• Ampicillin
  
• Augmentin
  
• Vancomycin
  
• Gentamicin
  
• Co-trimoxazole
  
• Imipenem

An aminopenicillin class antibiotic which is effective against streptococcus and some staphylococcus strains. It is generally ineffective against MRSA. Nephrotoxicity of ampicillin is relatively low compared to other antibiotics.

An aminopenicillin combination drug of amoxicillin and clavulanic acid, the use of clavulanic acid as a beta-lactamase inhibitor makes it more effective at fighting against beta-lactamase producing staphylococcus and provobacter. It remains ineffective against MRSA. Nephrotoxicity of augmentin is moderately low.

A glycopeptide antibiotic that is generally effective against most gram-positive bacteria such as streptococcus, staphylococcus, and MRSA. It remains ineffective against gram-negative strains. Nephrotoxicity of vancomycin is relatively high.

An aminoglycoside antibiotic that is very effective against gram-negative bacteria, such as pseudomonas and provobacter. Nephrotoxicity of gentamicin is relatively high.

A combination drug of trimethoprim and sulfamethoxazole, it is effective against a wide variety of gram-positive bacteria. Nephrotoxicity of co-trimoxazole is moderate.

A carbapenem class antibiotic that is effective against beta-lactamase producing bacteria as well as gram-negative bacteria. It is ineffective against MRSA. Nephrotoxicity of imipenem is moderate.

An infection can easily be diagnosed when it enters the blood stream by using a hematology analyzer. Diagnosing infections during the limb stage is a lengthier process. A culture sampler and culture tube are required to make a diagnosis.




To use the sampler, insert the culture tube into the sampler. By using the sampler in the health interface, it will attempt to grab a sample and place it into the culture tube. The order at which it will attempt to take a sample is as follows:

• If the limb is draining pus or has an abscess, the sampler will grab a pus sample
  
• If a limb is not draining or has an abscess, but the skin is retracted on that limb, it will grab a tissue sample
  
• If there is no pus/abscess/skin retraction on a limb, the sampler will get a blood sample instead (if there are multiple blood infections, it will grab a random sample)

After taking a sample, the sampler will place the new culture sample into your inventory (it may fall on the floor if you have a full inventory). The sample will remain unconfirmed until you analyze it with a culture analyzer, but before you do that you must incubate the sample. Samples will slowly grow on their own, but the growth can be expedited by using an incubator/incubator crate.




The incubator is faster than the incubator crate and has more slots, but the crate has the obvious advantage of being more portable. Once the sample incubates fully, place the sample into a culture analyzer to analyze it (it will need to be plugged in).



Once analyzed, the sample will tell you which pathogen it is. Treat the patient accordingly with the right antibiotics. Sometimes an analyzed sample will yield nothing. This is because the sample was empty upon collection.

I am not sure about keeping this feature as a long-term thing, and at the moment this is only a test thing right now, so depending on feedback I may or may not change/remove this feature.


Aside from wound infections, patients may develop other communicable diseases. Some common diseases which plague much of Europan society include the Iovipneumoviridae family of viruses, which is known to cause several respiratory diseases in humans.

Dubbed the "Europan cough" by many of the dwellers of Europa, these infections can range from mild to severe depending on pre-existing conditions. Most cases will resolve themselves and may only present as a cough with fever, though some cases can be severe enough to cause respiratory failure and lung damage.

Some common symptoms of the Europan cough include:

• Cough
  
• Fever
  
• Shortness of breath

More severe cases may present with:

• Nausea
  
• Chest pain
  
• Weakness and fatigue
  
• Headache

Spread is primarily through respiratory droplets from coughing. It is generally advisable to avoid standing close to those who are sick. Some preventative measures can be taken to avoid infection, such as wearing a mask and distancing yourself from the infected.

It is generally advisable for both healthy and infected individuals to wear masks (surgical mask) to minimize spread, and for infected individuals to take an antitussive (dextromethorphan) to reduce spread by coughing. Wearing a suit/diving mask will also lessen spread. The use of an antitussive and painkillers will alleviate symptoms.



Europan cough can be treated with remdesivir, which will slow the infection down and provide your immune system with more time to respond. Remdesivir overuse will lead to liver damage.

Confirmed culture samples can be used to craft certain items. Confirmed culture samples can also be duplicated by inoculating another culture tube. Simply craft a full-grown confirmed sample with a culture tube to create a duplicate. However, both samples will require being incubated again.

A vaccine can be created for a specific pathogen given that you have the culture samples on hand. You will need 3 full-grown samples along with anaparalyzant, tonic, and saline to craft two vaccines.



Vaccines will give your immune system a massive advantage over infections, though there are still some caveats to vaccines.

First, vaccines will not render a patient completely immune to an infection. Some infections that are very severe may still flare up with symptoms, though will likely be beaten by the immune system over time. If the immune system is compromised however, vaccines will not protect the patient at all.

Second, vaccines will lose efficacy over time. This means that a freshly injected vaccine will provide the patient with the best effect, while a patient who was injected a while ago will only have some protection from an infection until it wears off fully. Keep your crew's vaccinations up to date! You can check the level of vaccination in a patient with the hematology analyzer.

(Fun fact, no viable vaccines for these infections exist in the real world yet. I'm only adding them here because of the suspension of disbelief that perhaps these vaccines were invented by this time)

You can create a syringe filled with a specific pathogen given you have the culture samples on hand. You will need 2 full-grown samples along with some stabilozine.



These syringes can be fired out of syringe guns, injected by swinging, or injected discreetly by the health interface. It will start a blood infection in the target.

You can inoculate a culture tube with one of these syringes in the medical fabricator.

Infections can cause several diseases which can complicate recovery.

An infection of the inner layer of skin. Presents on the skin with a patch of redness. Will only cause minor damage.

To treat cellulitis, treat the underlying infection with the proper antibiotics, and it will resolve itself.

An infection of the lungs which can cause coughing, chest pain, and shortness of breath. Pneumonia can be confirmed with the health scanner. A patient may have a chance of contracting pneumonia if there is bacteria in the blood stream. If left untreated, pneumonia will make it difficult for the patient to breath and may cause respiratory arrest.

To cure pneumonia, treat the underlying blood infection with the proper antibiotics.

A rare infection of the fascial lining. A patient may contract this if a limb is infected and their immune system is suppressed. This infection will grow and cause extensive damage to the limb. The necrotic tissue will act as another source of infection and will increase the risk for sepsis.

To treat necrotizing fasciitis, use the proper antibiotics to slow down the growth of infected tissue, and open the limb surgically. Then use a scalpel to debride the infected tissue (be thorough about it). This will lead to an extensive amount of lacerations. Should debridement be too difficult or risky, amputation is another solution.

Along with the primary additions, there are some other changes this mod makes including:

• Radiation sickness will compromise immunity after a certain point
  
• Sepsis will lower blood pressure
  
• Some existing afflictions will have new symptoms