Tetanus is caused by Clostridium tetani, an obligatory anaerobic Gram-positive bacillus. It remains a threat in many developing countries. Clinical manifestations include muscle rigidity, spasms, and autonomic disturbances. Treatment involves benzodiazepines, antibiotics such as penicillin and metronidazole, and vaccination to prevent further cases.

1. MANAGEMENT OF
TETANUS
Ade Wijaya, MD
November 2018

2. INTRODUCTION
Obligatory anaerobic Gram-positive bacillus Clostridium tetani.
Still a threat in many developing countries
Elimination of tetanus through vaccination
Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Critical care. 2014

3. PATHOPHYSIOLOGY

4. CLINICAL MANIFESTATION
 Trismus or “locked jaw”
 Generalized muscle rigidity, stiffness, reflex spasms, opisthotonus
and dysphagia
 Autonomic disturbances, such as swings in blood pressure,
arrhythmias, hyperpyrexia and sweating
 Exhaustion, autonomic disturbances, and complications from
muscle spasms (for example, asphyxiation, pneumonia,
rhabdomyolysis, pulmonary emboli) can contribute to the high fatality
rates observed in severe tetanus
Abrutyn E: Tetanus. In Harrison's Principles of Internal Medicine. 14th edition. Edited by: Isselbacher KL, Braunwald E, Wilson JD, Martin JB, Fauci AS, Kasper DL, Longo DL, Hauser SL. New York: McGraw Hill; 1998:901-9

5. TREATMENT MODALITIES
Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Critical care. 2014

6. TREATMENT MODALITIES
Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Critical care. 2014

7. TREATMENT MODALITIES
Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Critical care. 2014

8. TREATMENT MODALITIES
Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Critical care. 2014

9. SUMMARY
Obligatory anaerobic Gram-positive bacillus Clostridium tetani.
Still a threat in many developing countries
Elimination of tetanus through vaccination
Treatment core:
Benzodiazepine and antibiotics (penicillin and metronidazole)