Tetanus

Tetanus is a serious, acute condition that is caused by infection with a bacterium (Clostridium tetani).The bacteria are often found in soil,dust,manure. The incubation period is 4 to 21 days.

Classification—

Cephalic tetanus

Primarily affects muscles of the face only.

Generalized tetanus

Affects all skeletal muscles. Most common and most severe form.

Local tetanus

Manifests with muscle spasms at or near the wound that has been infected with the bacteria.

Neonatal tetanus

Is identical to generalized tetanus except that it affects neonates (less than 1 month old) only.

Causes—

  • Abrasions and lacerations
  • Animal bites
  • Body piercing and tattoos
  • Burns
  • Circumcision
  • Injury or wound
  • Intravenous drug use
  • Not being immunized against tetanus

Symptoms And Signs—

General

  • Drooling
  • Dysphagia
  • Excessive sweating
  • Fever
  • Irritability
  • Muscle rigidity and spasms.
  • Sudden, powerful, and painful contractions of muscle groups(tetany). These episodes can cause fractures and muscle tears
  • Uncontrolled defecation
  • Urine incontinence

Specific

Generalized Tetanus

  • Muscle cramps
  • Opisthotonus
  • Risus sardonicus
  • Sore muscles
  • Spasm of respirarory muscles
  • Spasms of the vocal cords
  • Trismus
  • Weakness
  • Death

Cephalic Tetanus

  • Lockjaw
  • Progresses to generalized tetanus

Localized Tetanus

  • Muscle spasms occur at or near the site of the injury.
  • Progresses to generalized tetanus.

Neonatal Tetanus

  • Irritability
  • Poor sucking ability
  • Dysphagia

Investigations–

Blood test to identify the tetanus bacteria.

Treatment–

  • Medicines
  • Bed rest with a non-stimulating environment
  • Dim light
  • Reduced noise
  • Stable temperature
  • Tetanus immune globulin
  • Muscle relaxers
  •  Sedatives
  • Surgery
  • Breathing support with ventilators

Complications —

  • Acute renal failure
  • Bone fractures
  • Brain damage
  • Dysponea   
  • Disability
  • Heart failure
  • Pneumonia
  • Respiratory failure

Prevention–

  • Tetanus is completely preventable by active tetanus immunization. Immunization is thought to provide protection for 10 years.
  • Older teenagers and adults who have sustained injuries, especially puncture-type wounds, should receive booster immunization for tetanus if more than 10 years have passed since the last booster.
  • Debridement reduces the risk of developing tetanus.

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