Tetanus

Clostridium tetani

Clostridium tetani:
*gram positive bacillus
*strict anearobe
*lophotrichous flagella (think horsetail)
*spore forming
*produces two toxins (tetanospasmin/tetanus toxin) and (tetanolysin)

*Tetanospasmin (tetanus toxin)
*Tetanolysin

Environment (soil and animal)

*pareneteral route (liquids given via IV)
*non-communicabe (except during birth)

3-21 days

*spores germinate and colonize anearobic wounds
*tetanospasmin toxins secreted
*toxins enter motor neurons and circulatory systems, eventually end up in CNS
*toxins in CNS target inhibitory neurons= results in sustained muscle contraction (tetanus)

*severe pain
*muscle spasms
*seizures (jerking or staring)
*headaches
*fever and sweating
*changes in blood pressure and heart rate

*progressive worsening over two weeks

*Local (muscles at site of infection)
*Cephalic (cranial nerve muscles)
*Neonatal (weakness, rigidity, failure to nurse)

*spasms that obstruct upper airway or diaphragm
*broken bones
*autonomic dysfunction (heart, lungs, digestive system, sweat glands, pupils, blood vessels)
*blood clots
*secondary infections
*recurrent tetanus
*mortality

90%

*Toxoid vaccination
-Dtap (young, all below age 6)
-Tdap (teenage years)
-Td (10 yrs after age 29)
*Disinfect spores

*Ventilation
*Benzodiazepines (GABA) agonists, they reduce CNS excitability
*passive immunizations (provide antibodies for the body, short term protection against infection) with human tetanus immune globulin (HTIG)
*vaccination
*Antibiotics (metronidazole)

*metronidazole (remember that is used for trichomoniasis)