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    Tetanus

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    Tetanus is caused by Clostridium tetani bacteria found in soil and dust. It produces a neurotoxin that causes painful muscle spasms. Symptoms range from lockjaw to painful arching of the back. It is endemic in developing nations and a major cause of neonatal mortality. Treatment focuses on wound care, antitoxin administration, and supportive care for spasms while the toxin is neutralized.

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    Tetanus

    Uploaded by

    Kidist
    7 views12 pages
    Tetanus is caused by Clostridium tetani bacteria found in soil and dust. It produces a neurotoxin that causes painful muscle spasms. Symptoms range from lockjaw to painful arching of the back. It is endemic in developing nations and a major cause of neonatal mortality. Treatment focuses on wound care, antitoxin administration, and supportive care for spasms while the toxin is neutralized.

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    Tetanus is caused by Clostridium tetani bacteria found in soil and dust. It produces a neurotoxin that causes painful muscle spasms. Symptoms range from lockjaw to painful arching of the back. It is endemic in developing nations and a major cause of neonatal mortality. Treatment focuses on wound care, antitoxin administration, and supportive care for spasms while the toxin is neutralized.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    7 views12 pages

    Tetanus

    Uploaded by

    Kidist
    Tetanus is caused by Clostridium tetani bacteria found in soil and dust. It produces a neurotoxin that causes painful muscle spasms. Symptoms range from lockjaw to painful arching of the back. It is endemic in developing nations and a major cause of neonatal mortality. Treatment focuses on wound care, antitoxin administration, and supportive care for spasms while the toxin is neutralized.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 12

    Tetanus

    By Dr. Haile Onado.(MD,pediatrics resident)


    Tetanus
    • An acute, spastic paralytic illness caused by
    tetanus toxin (tetanospasmin), the neurotoxin
    produced by Clostridium tetani
    Etiology
    • C. tetani, a motile gram + spore forming
    obligate anaerobe whose natural habitat is
    soil, dust & alimentary tract of animals
    • Can survive boiling
    Epidemiology
    • Endemic in 90 developing countries
    • Most common form – neonatal (umbilical) tetanus,
    killing ~500,000 infants each year
    • ~80% of deaths occur in just 12 tropical Asian &
    African countries
    • Additionally, 15,000 – 30,000 Unimmunized
    mothers die each year from:
     maternal tetanus result from post-partum, post-abortal
    & post-surgical wound infection
    • Most non-neonatal cases associated with traumatic
    injury by a dirty object
    Pathogenesis
    Corticospinal N
    Descending SN

    Inhibitory Interneuron

    Alpha motoneuron

    Adrenal
    Medulla
    muscle
    NMJ
    Pathogenesis
    • Introduced spores germinate, multiply &
    produce tetanospasmin and tetanolysin at an
    infected injury site
     Tetanolysin damages viable tissue increasing the
    volume of tissue for multiplication of the organism
    • Tetanus toxin binds at neuromuscular
    junction ➞ retrograde axonal transport to
    cytoplasm of alpha motoneuron cells (3.4 mm/hr)
    Pathogenesis
    • Exit alpha motoneuron & enter adjacent
    inhibitory interneuron ➞ blocks normal
    inhibition of agonist and antagonistic muscles
    ➞ tetanic spasms
    • It can block also inhibition of the
    intermediolateral neurons that control
    adrenal medulla ➞ autonomic disturbances
    Clinical Manifestation
    • Incubation period – 2 to 14 days commonly;
    but can be as long as months after the injury
    • Can be divided in to two:
    • Generalized tetanus –
     Trismus or lock jaw (masseter muscle spasm) is
    presenting symptom in about 50%
     Headache, restlessness, and irritability are early
    symptoms often followed by stiffness, dysphagia and
    neck muscle spasm
    Clinical manifes…..
     Opisthotonus – arched posture due to involvement of
    abdominal, lumbar, hip and thigh muscles (“board” like
    rigidity in which the back of the head and heals touch
    ground)
     Laryngeal and respiratory muscle spasm can lead to
    airway obstruction and asphyxiation
     Risus Sardonicus (sardonic smile) results from
    intractable spasm of facial and buccal muscles
     Patient remains conscious in extreme pain and
    anticipation of next tetanic seizure
     Tetanic spasm may be triggered by the smallest
    disturbance (sight, sound or touch)
    Clinical manifes….

    • High grade fever – due to a catabolic state


     Autonomic NS manifestations: tachycardia, arrhythmias,
    labile hypertension, diaphoresis and cutaneous
    vasoconstriction
     Tetanic paralysis become more intense in the first week
    after onset, and stabilizes over the ensuing one to four
    weeks
    • Neonatal tetanus (Tetanus Neonatrum):
     Infantile type of generalized tetanus
     Typically manifests with in 3 – 12 days of birth
     Difficulty in feeding, crying, paralysis, stiffness to touch
    with or without opisthotonus are characteristics
    Clinical…
    • Localized tetanus
    Painful spasm of muscles adjacent to the wound site
    May precede generalized tetanus
    • Cephalic tetanus:
    A rare form of localized tetanus involving the bulbar
    musculature
    Follow wounds or foreign bodies in the head, nostrils
    or face, and occasionally chronic otitis media
    Characterized by retracted eye lids, deviated gaze,
    trismus, risus sardonicus and spastic paralysis of the
    tongue
    Diagnosis

    • No diagnostic lab test


    • Based on Hx and clinical finding
    • Differential diagnosis:
    Strychnine poisoning
    Meningitis
    Peritonitis
    Rabies
    Dental abscess
    Hypocalcemic tetany
    Treatment
    • Principles
    Eradication of C. tetani and wound
    environment conducive for its multiplication
    Neutralization of all accessible tetanus toxin
    Control of spasms
    Provision of meticulous supportive care
    Prevention of recurrences

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