Tetanus

Tetanus

Clostridium tetani

GPR, Strict anearobe, lophotrichous flagella, spore forming, produces 2 toxins; Tetanospasim and Tetanolysin

Enviroment (soil and animals)

Open Wound (70% of US cases come from puncture or laceration)

Parenteral Route, Non-Communicable (except during birth)

3-21 days

Spores germinate and colonize anearobic wounds. secreted Tetanospasmin toxins enter motor neurons or circulatory system and are transported to the CNS where they target inhibitory neurons resulting in sustained muscle contraction

Severe pain; Muscle Spasms: General- increased tone of orbicularis oris, “lockjaw,” trouble swallowing, abdominal rigidity, opisthotonos (curvature of the back); Local- affects muscles at the site of infection; Cephalic- affects cranial nerve muscles; Neonatal- weakness, rigidity, failure to nurse; jerking or staring (seizures); headache, fever and sweating, changes in blood pressure and a fast heart rate, PROGRESSIVE worsening over 2 weeks

Spasms obstructing upper airway or diaphragm, broken bones, autonomic dysfunction, blood clot, secondary infection, recurrent tetanus, Mortality in neonatal is 90%

Toxoid Vaccine-DTaP, Tdap, Td (every 10 yrs), disinfect for spores

Ventilation, Benzodiazepines GABA agonists, Passive immunizations with human tetanus immune globin (HTIG), Vaccination, Antiboitics/Metronidazole