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.

1. TETANUS
Vd Rakesh Shukla
Lecturer,
Dept of Swasthavritta
GAAC, Ahmedabad
Vd Rakesh Shukla, GAAC, Ahmedabad

2. INTRODUCTION
• Tetanus is an 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 is an 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 is a 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
• Natural habit 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
• Generally less than 2 weeks
• Also range from 2- 60 days
• Shorter period indicate greater risk
Vd Rakesh Shukla, GAAC, Ahmedabad

10. TYPES
• On the basis 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
• Effects all 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
• Local tetanus involves the facial muscles only
• Can be unilateral or bilateral.
Vd Rakesh Shukla, GAAC, Ahmedabad

16. NEONATAL TETANUS
• Occurs within 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 on clinical findings
• Elevated leukocyte count
• Normal cerebrospinal fluids
• Electromyograms may show continuous discharge motor
units
Vd Rakesh Shukla, GAAC, Ahmedabad

18. DIFFERENTIAL
DIAGNOSIS
• Should be differentiated from
• Local cause of trismus
• Distonia
• meningoencephalitis
• strychnin poisoning
Vd Rakesh Shukla, GAAC, Ahmedabad

19. TREATMENT
• Wounds must be 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 control by diazepam
• Tracheostomy to maintain the patency of airways
• Nutritional supply
• Fluid electrolyte balance
Vd Rakesh Shukla, GAAC, Ahmedabad

21. PREVENTION
o Actively immunize by 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

22. Thank you.
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Vd Rakesh Shukla, GAAC, Ahmedabad