Tetanus, also known as lockjaw, is an infection characterized by muscle spasms. It is a disease that results from wound infection with clostridium tetani (spore forming, anaerobic bacteria). The injury may be a trivial nail prick, a contaminated surgical wound, a gun shot wound or an infected umbilical stump.
At the site of infection the spores germinate. The toxin is released and reaches the CNS by retrograde axonal transport or via the blood stream where it becomes fixed to gangliosides in spinal cord and brain stem and exerts its action.
Cause
1. Tetanus is caused by the tetanus bacterium Clostridium tetani.
2. Tetanus is often associated with rust, especially rusty nails.
3. Clostridium tetani, are found in soil, dust and animal feces.
4. When they enter a deep flesh wound, spores of the bacteria may produce a powerful toxin, tetanospasmin, which actively impairs your motor neurons, nerves that control your muscles.
Incubation Period
The incubation period of tetanus may be up to several months, but is usually about eight days. In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 days.
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Signs and Symptoms
1. Mild spasms in the jaw muscles—also known as lockjaw or trismus
2. The spasms can also affect the chest, neck, back, abdominal muscles, and buttocks.
3. Drooling
4. Excessive sweating
5. Fever
6. Hand or foot spasms
7. Irritability
9. Difficulty swallowing
10. Uncontrolled urination or defecation
11. Opisthotonos
Diagnosis
1. A simple test involves touching the posterior pharyngeal wall with a spatula or tongue blade.
2. Usually, this test causes a gag reflex with the patient, and the patient tries to expel the spatula. (This means they have tested negative)
3. In tetanus, patients develop a reflex spasm of the masseters and bite the spatula. (a positive test).
Treatment
Mild cases of tetanus can be treated with :
1. Tetanus immunoglobulin, also called tetanus antibodies or tetanus antitoxin. It can be given as intravenous therapy or by intramuscular injection.
2. Metronidazole IV for 10 days
3. Diazepam oral or IV
Severe cases will require admission to intensive care. In addition to the measures listed above for mild tetanus :
1. Human tetanus immunoglobulin injected intrathecally (increases clinical improvement from 4% to 35%)
2. Tracheotomy and mechanical ventilation for 3 to 4 weeks. Tracheotomy is recommended for securing the airway because the presence of an endotracheal tube is a stimulus for spasm
3. Magnesium, as an intravenous (IV) infusion, to prevent muscle spasm
4. Diazepam as a continuous IV infusion
5. The autonomic effects of tetanus can be difficult to manage (alternating hyper- and hypotension hyperpyrexia/hypothermia) and may require IV labetalol, magnesium, clonidine, or nifedipine
Prevention
1. Tetanus can be prevented by vaccination with tetanus toxoid.
2. The tetanus vaccine usually is given to children as part of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. This vaccination provides protection against three diseases: a throat and respiratory infection (diphtheria), whooping cough (pertussis) and tetanus.
Related Article :
- Tuberculosis (TB)
- Bacteria
- Top 10 Most Painful Medical Conditions
At the site of infection the spores germinate. The toxin is released and reaches the CNS by retrograde axonal transport or via the blood stream where it becomes fixed to gangliosides in spinal cord and brain stem and exerts its action.
Cause
1. Tetanus is caused by the tetanus bacterium Clostridium tetani.
2. Tetanus is often associated with rust, especially rusty nails.
3. Clostridium tetani, are found in soil, dust and animal feces.
4. When they enter a deep flesh wound, spores of the bacteria may produce a powerful toxin, tetanospasmin, which actively impairs your motor neurons, nerves that control your muscles.
Incubation Period
The incubation period of tetanus may be up to several months, but is usually about eight days. In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 days.
Related Article :
- Tuberculosis (TB)
- Bacteria
- Top 10 Most Painful Medical Conditions
Signs and Symptoms
1. Mild spasms in the jaw muscles—also known as lockjaw or trismus
2. The spasms can also affect the chest, neck, back, abdominal muscles, and buttocks.
3. Drooling
4. Excessive sweating
5. Fever
6. Hand or foot spasms
7. Irritability
9. Difficulty swallowing
10. Uncontrolled urination or defecation
11. Opisthotonos
Diagnosis
1. A simple test involves touching the posterior pharyngeal wall with a spatula or tongue blade.
2. Usually, this test causes a gag reflex with the patient, and the patient tries to expel the spatula. (This means they have tested negative)
3. In tetanus, patients develop a reflex spasm of the masseters and bite the spatula. (a positive test).
Treatment
Mild cases of tetanus can be treated with :
1. Tetanus immunoglobulin, also called tetanus antibodies or tetanus antitoxin. It can be given as intravenous therapy or by intramuscular injection.
2. Metronidazole IV for 10 days
3. Diazepam oral or IV
Severe cases will require admission to intensive care. In addition to the measures listed above for mild tetanus :
1. Human tetanus immunoglobulin injected intrathecally (increases clinical improvement from 4% to 35%)
2. Tracheotomy and mechanical ventilation for 3 to 4 weeks. Tracheotomy is recommended for securing the airway because the presence of an endotracheal tube is a stimulus for spasm
3. Magnesium, as an intravenous (IV) infusion, to prevent muscle spasm
4. Diazepam as a continuous IV infusion
5. The autonomic effects of tetanus can be difficult to manage (alternating hyper- and hypotension hyperpyrexia/hypothermia) and may require IV labetalol, magnesium, clonidine, or nifedipine
Prevention
1. Tetanus can be prevented by vaccination with tetanus toxoid.
2. The tetanus vaccine usually is given to children as part of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. This vaccination provides protection against three diseases: a throat and respiratory infection (diphtheria), whooping cough (pertussis) and tetanus.
Related Article :
- Tuberculosis (TB)
- Bacteria
- Top 10 Most Painful Medical Conditions
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