i made a presentation on clinical features of TETANUS and here it is...

1. Clinical features of
Tetanus
By PBL Group D
BMCTH, 4th Batch
TUTOR: Dr. C.P. GAIRE

2.  Samita Mandal
Chandan Bharti
Rachana Mishra
Subha Mishra
Naman Kumar
Rashila Nepal
Adarsha Neupane
Tek Raj Oli
Anjila Poudyal
Moneec Pokharel
Rasmita Poudel
Regina Rai
Ritesh Ray
GROUP D MEMBERS:

3. WHAT IS

5. Incubation Period (IP): Time from
injury to the first symptom. The
median incubation period is 7 days.
The shorter the incubation period,
the higher the
chance of death.

6. Triad of muscle rigidity, spasms & autonomic
dysfunction.

7. Early Symptoms:
•Neck stiffness
With sore throat and poor
mouth opening

8. • Lockjaw
Patients with generalized tetanus present with Trismus
a.k.a. lockjaw in 75% of cases.

9. Risus sardonicus: Sustained contraction of facial
musculature produces a sneering grin
expression known as risus sardonicus.
Opisthotonus: Spasm of extensor
of the neck, back and legs to form
a backward curvature.

10. • Other symptoms include stiffness, restlessness,
dysphagia and reflex spasms. Spasms usually
continue for 3-4 weeks.

11. • Muscle rigidity spreads in a descending
pattern from the jaw and facial muscles to the
extensor muscles of the limbs – stiff
proximal limb muscles & relatively sparing
hand & feet.
Over the next 24-48 hours

12. Other symptoms include:
• Drooling
• Fever usually absent
• Mentation unimpaired
• Hand or foot spasms
• Uncontrolled urination or defecation

14. MUSCLE
RIGIDITY
LOCK JAW
STIFF NECK
DIFFICULTY
SWALLOWING
SPASMS
Sequence of Tetanus

15. Types of TETANUS
• Generalized tetanus
• Neonatal tetanus
• Local tetanus
• Cephalic tetanus

16. Generalized tetanus
The generalized form usually presents with a
descending pattern. The first sign is lockjaw, and the
facial spasms called risus sardonicus, followed
by stiffness of the neck, difficulty in swallowing, and
rigidity of pectoral and calf muscles

17. Neonatal tetanus
• Neonatal tetanus is a form of generalized tetanus
that occurs in newborns, usually those born to
mothers who themselves have not been vaccinated.

19. Local tetanus
• Local tetanus is an uncommon form of the disease,
in which patients have persistent contraction of
muscles in the same anatomic area as the injury.
The contractions may persist for many weeks
before gradually subsiding. Local tetanus is
generally milder; only about 1% of cases are fatal,
but it may precede the onset of generalized tetanus

20. Cephalic tetanus
• Cephalic tetanus is the rarest form of the disease (0.9–3% of cases) and is
limited to muscles and nerves in the head. It usually occurs after trauma to
the head area, including skull fractures.
• Cephalic tetanus is more likely than other forms of tetanus to be fatal, with
the progression to generalized tetanus carrying a 15–30% case fatality rate