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Tetanus
Tetanus is an acute infectious disease caused by toxins produced by Clostridium tetani bacteria. The bacteria typically enters the body through a wound and produces a neurotoxin called tetanospasmin that causes painful muscle spasms. There are four main types of tetanus - generalized, local, cephalic, and neonatal. Symptoms include muscle rigidity, lockjaw, and painful spasms. Treatment involves wound cleaning, antitoxins to neutralize circulating toxins, antibiotics, and managing symptoms. Prevention focuses on active immunization with booster shots every 10 years and proper wound care.
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Tetanus
- 1. TETANUS Vd Rakesh Shukla Lecturer, Deptof Swasthavritta GAAC, Ahmedabad Vd Rakesh Shukla, GAAC, Ahmedabad
- 2. INTRODUCTION • Tetanus isan acute infectious disease.: • Also known as lock jaw & 8.th day diseases. • One among 6 killer diseases. • Occurs through wound contamination. Vd Rakesh Shukla, GAAC, Ahmedabad
- 3. DEFINITION • Tetanus isan acute infectious diseases induced by exotoxin of clostridium tetani & characterized by rigidity, intermittent spasm of the voluntary muscles &convulsions.. • Tetanus occurs when a wound becomes infected with bacterial spores. Vd Rakesh Shukla, GAAC, Ahmedabad
- 4. Vd Rakesh Shukla,GAAC, Ahmedabad
- 5. AGENT • Cl.tetani isa gram-positive, anaerobic, spore bearing &highly resistant organism • Remains strictly localized to the site of multiplication • Produce exotoxin. 1. a powerful neurotoxins- tetanospasmin-resposible for clinical diagnosis because it causes disinhibition of motor system leading to muscle rigidity 2. a hemolysin -tetanolysin • Lethal dose- 0.1mg for 70 kg man. Vd Rakesh Shukla, GAAC, Ahmedabad
- 6. PATHOLOGY • SEQUENCE IS;- • Introduction of the spores • Germination • Elaboration of the toxins • binding to the receptor Vd Rakesh Shukla, GAAC, Ahmedabad
- 7. RESERVOIR OF INFECTION • Naturalhabit is soil &dust • Also found in the intestines of many herbivorous animals e.g. cattle, horses, goat, • Excreted in their faeces of animals Vd Rakesh Shukla, GAAC, Ahmedabad
- 8. HOST FACTORS • AGE: Active age(5-40) • SEX : Higher incidents found in males • OCCUPATION : Agriculture workers at a special risk because of contact with soil • IMMUNITY : No age is immune unless protected by previous immunization. • Tetanus toxoids effective for several years Vd Rakesh Shukla, GAAC, Ahmedabad
- 9. INCUBATOIN PERIOD • Generallyless than 2 weeks • Also range from 2- 60 days • Shorter period indicate greater risk Vd Rakesh Shukla, GAAC, Ahmedabad
- 10. TYPES • On thebasis of clinical findings divided in to four • 1)Generalized tetanus • 2)Neonatal tetanus • 3)Local tetanus • 4)cephalic tetanus Vd Rakesh Shukla, GAAC, Ahmedabad
- 11. SIGNS & SYMPTOMS •Vague discomfort • Pain around the site of injury & restlessness • Increased tone of masseter muscle • dysphagia • Abdominal & trunk muscles become spastic • With prolonged &sustained spasm leads to muscular exhaustion, hypertension &cardiac failure. Vd Rakesh Shukla, GAAC, Ahmedabad
- 12. • Rigidity &spasm of the back muscles result in hypertension of spine & neck-opisthotonous • Grinning expressions brought about by the sustained contraction of facial muscles-Risus sardonicus • Interval between the first symptom & the first convulsions is called –onset period Vd Rakesh Shukla, GAAC, Ahmedabad
- 13. GENERAL TETANUS • Effectsall skeletal muscles • Most common &most severe Vd Rakesh Shukla, GAAC, Ahmedabad
- 14. LOCAL TETANUS • Rigidity& other symptoms confine to parts near the site of injury • It’s a mild course &ends in complete recovery Vd Rakesh Shukla, GAAC, Ahmedabad
- 15. CEPHALIC TETANUS • Localtetanus involves the facial muscles only • Can be unilateral or bilateral. Vd Rakesh Shukla, GAAC, Ahmedabad
- 16. NEONATAL TETANUS • Occurswithin 10 days of birth • Manifests as inability to suck the the nipple, irritability & excessive crying • Infection of the umbilical stump • major cause of infant mortality Vd Rakesh Shukla, GAAC, Ahmedabad
- 17. DIAGNOSIS • Entirely onclinical findings • Elevated leukocyte count • Normal cerebrospinal fluids • Electromyograms may show continuous discharge motor units Vd Rakesh Shukla, GAAC, Ahmedabad
- 18. DIFFERENTIAL DIAGNOSIS • Should bedifferentiated from • Local cause of trismus • Distonia • meningoencephalitis • strychnin poisoning Vd Rakesh Shukla, GAAC, Ahmedabad
- 19. TREATMENT • Wounds mustbe cleaned • Neutralize the toxins already in circulation by antitoxins • Give ATS(anti tetanus serum) intravenously or intramuscularly • Antibiotics penicillium &benzyl penicillin-0.5mega unit 6 hourly Vd Rakesh Shukla, GAAC, Ahmedabad
- 20. • Convulsion controlby diazepam • Tracheostomy to maintain the patency of airways • Nutritional supply • Fluid electrolyte balance Vd Rakesh Shukla, GAAC, Ahmedabad
- 21. PREVENTION o Actively immunizeby 3 doses- o Booster dose every 10 years o Active immunization of pregnant women o Primary care of the wounds o Penicillin therapy reduce the risk Vd Rakesh Shukla, GAAC, Ahmedabad
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