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.
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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.
