1. Tetanus is caused by Clostridium tetani bacteria which produces a toxin that causes painful muscle contractions. It enters through wounds and infects locally. 2. Symptoms include jaw stiffness, muscle spasms, and potentially death from respiratory failure. Treatment involves wound care, antibiotics, tetanus immunoglobulin, muscle relaxants, and sometimes ventilation in ICU. 3. Scabies is caused by the Sarcoptes scabies mite which burrows under the skin and causes itching. Symptoms include pustules, vesicles, and scratches between fingers and skin folds. Treatment involves scabicide creams or ointments applied to the entire body for

1. Other infectious Disease
Tetanus
Scabies

2. Objective
At the end of this session students will be able
to
1. Define tetanus
2. Explain C/M of tetanus
3. Explain the tetanus management and
prevention
4. List condition/wounds that favors tetanus
5. Discuss scabies

3. Tetanus (Lock jaw)
Tetanus is an acute bacterial disease caused
by a toxin produced by tetanus bacilli
characterized by pain full contraction of
voluntary muscle

4. Tetanus- Eithopathogenesis
 Tetanus is caused by clostridium tetani gram-
negative rod, obligate anaerobic terminal spore
forming bacteria.
 The spore is highly resistant to drying and
temperature
 The organism found naturally in soil, horse and
cattle dung, less commonly and human excrete
sometimes in those who have association with
cattle.
 Tetanus most likely develop in deep penetrating
wounds with tissue necrosis

5. Tetanus- Eithopathogenesis
Wounds those favours tetanus are
Umbilical stamp in new born
Deep (stab) wounds
Burns
Endometrities after abortion
Surgical wounds from dressing or instruments
Chronic ulcer
 Any other wounds
Organism multiplies anaerobically in deep
wound and produce toxin which can be
transported to CNS and affects Nerves.

6. Tetanus cont’d
Reservoir:
Intestine of animals, Soil
MT
 Through punctured wound contaminated with animal
dung ,street dust
PC
Not directly transmitted from person to person
Susceptibility and resistance
General
Active immunity is induced by tetanus toxoid and persists
for at least 10 years
IP
3-21 day’s in average
Short incubation period indicates sever disease

7. Tetanus -C/M
¨ Stiffness of jaw with inability to open mouth fully
is the1st symptom.
¨ Risus sardonicus- sustained contraction
¨ Tetanus spasm develops with in 24-72hr, the
shorter this period, the poorest the prognosis.
¨ Pts are fully conscious
¨ Minor stimuli like sound, light or touch can
precipitate the pain full spasm.
¨ Dyspagia, hyper reflexia and fevers are invariable.
¨ There is no bacteraemia and organism localized
to the wound

8. Tetanus-C/M cont’d
Death from tetanus occur due to
Spasm of glottis, thoracic mussel and diaphragm
Chronic hypoventilation
periods of apnoea
Aspiration and subsequent suffocation
Inability to suck is the first symptom in new born
Inability to suck is the first symptom in new
born
Dx
Clinical

9. Tetanus- Mx
Non drug Mx
¨ Admit pt in quit place, in sever cases ICU if
possible for continuous cardio pulmonary
monitoring
¨ Wound care
¨ Intubations or tracheotomy if possible
¨ Nutrition through NGT

10. Tetanus- Mx cont’d
Drug Mx
1 Control of spasm by
Diazepam 10 mg IV Q 4hr or Phenobarbitone 50-
100mg Q.6hr Plus, chlorpromazine 25-50mg IM
Q6 hr alternated with diazepam
2.Antibiotics
Metronidazole 500mg PO TID for 7-10 days
Crystalline penicillin

11. Tetanus- Mx cont’d
3 Tetanus Human immunoglobulin 500 IU IM
once
4 ATS (anti tetanus serum) + (IG ) 500 IU IM
10,000 units IM /IV for both adult& children
Give test dose first, keeping adrenaline at hand
5 Propronanol for ANS dysfunction 60mg PO/d

12. Tetanus- Mx cont’d
6 Surgical RX
Look for wound & clean with normal saline
and H2O2
Operative procedures are not recommended
b/c sever, uncontrolled spasm commonly
accompany surgery
Tracheotomy ( sever case)

13. Tetanus- Mx cont’d
7. Admission to ICU
Nursed is dark & isolated room
AR if Pt develops breathing arrest (tetanus is not
infections)
immediate sedation with spasm
Observation from minute to minute
Semi-prone position (never on back)
Change position every 2 hrs
Rise the foot of bed to stimulate lung drainage
8 Toxoid (TT)

14. Tetanus Prevention & Control
¨ Active Immunization (PV/DPT)
¨ Active immunization with TT
¨ Passive protection ATS is only for 10 days so it
should not be given without active immunization
Tetanus of new born
¨ Active immunization of mother during pregnancy
¨ DPT Cannot replace TT
¨ Sterilization of equipments
¨ Proper care of wound

15. Scabies
Definition
 An infestation of the skin with itchy mite (sarcoptes
scabies; vor hominis)
Common site
 Space b/n finger
 wrist
 Hand
 axilla
 Extensor surface of elbow and knee
 Buttock
 groin region

16. Scabies cont’d
C/M
Pustule lesion
itchy scratch syndrome
Vesicle
excoriation
crust
Dx
Identification of sarcoptes scabies or mite under
microscope of any stage (adult, egg, larvae)
Clinical

17. Scabies cont’d
Rx-
1. BBL applied on the body daily for 3-5 days or
Sulfur ointment applied daily for 3 days.
2. Body bath before and after application
3. Treatment of the whole family
Prevention and control
Personal hygiene
Treat the whole family

18. Thank you