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Tetanus

Tetanus is a disease that results from wound infection with clostridium tetani. The injury may be a trivial nail prick, a contaminated surgical wound, a gun shot wound or an infected umbilical stump.

At the site of infection the spores germinate. The toxin is released and reaches the CNS by retrograde axonal transport or via the blood stream where it becomes fixed to gangliosides in spinal cord and brain stem and exerts its action.

Symptoms and signs

3 main types of clinical disease

  1. Generalized tetanus
  2. Localized tetanus.
  3. Tetanus neonatorum

Ophisthotonus: is a posture taken upon generalized convulsions in which there is hyperextension of back muscles.

Treatment

Local debridement and metronidazole to prevent further toxin production. Antitetanic serum (affects only circulating toxin, has no effect on fixed toxin). should be given on the grounds of clinical suspicion alone. Exclude allergy by SC injection first. Diazepam is used to control the convulsions.

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