Tetanus is caused by Clostridium tetani, a bacteria commonly found in soil and the intestines of humans and animals. The bacteria produces a toxin called tetanospasmin that affects the anterior horn cells of the spinal cord, causing painful muscle rigidity and convulsions. Symptoms include lockjaw (trismus), risus sardonicus (contraction of facial muscles), and board-like abdominal rigidity. Management of tetanus involves neutralizing the toxin with tetanus antitoxin, debriding wounds to prevent further toxin production, antibiotics to prevent secondary infections, muscle relaxants to control spasms, and maintaining hydration, nutrition, and a quiet environment for

1. TETANUS
DR. PUSHKAR KUMAR
MBBS,MD(GENERAL MEDICINE)
JUNIOR RESIDENT
DEPARTMENT OF MEDICINE
DMCH,LAHERIASARAI,DARBHANGA

2. Tetanus-opisthotonos

3. INTRODUCTION
• Normal commensal in gut both human and domestic animals.
• Tetanus neonatorum-8th day disease due to unhygienic practice of cutting
umbilical stump.
• Tetanospasmin - is an exotoxin that affect anterior horn cell- rigidity and
convulsions.
• Trismus-(lock jaw)- spasm of Masseter muscle, painless, diagnostic.
• Risus Sardonicus-contraction of Frontalis and muscles of angle of mouth
Contraction of orbicularis oculi,narrow palpebral fissure.
• Board like abdominal rigidity.
• ANS involvement.

29. SUMMARY OF MANAGEMENT
• 1) Neutralize absorbed toxin-3000 units of human tetanus antitoxin iv
• 2) Debride wound to prevent further toxin production
• 3)Benzyl penicillin-600 mg iv 4 times a day Allergic patient- metronidazole iv
• 4)Muscle relaxant-to control spasm
• 5)Avoid unnecessary stimulus-nursing in a quiet room
• 6) Sedation- iv diazepam
• 7) If spasm continue-paralyse the patient and ventilator Muscle relaxant- pancuronium
or diazepam with Morphin or Fentanyl
• 8)Maintain hydration and nutrition
• 9) Treat secondary infections
• 10) Destruction of Spores (esp in operation theatres) using autoclaves.

35. THANK YOU !!