Tetanus

Tetanus, also called lockjaw, is a serious infection caused by Clostridium tetani. This bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles. If Clostridium tetani spores are deposited in a wound, the neurotoxin interferes with nerves that control muscle movement

1. TETANUS
VdRakeshShukla
Lecturer,
DeptofSwasthavritta
GAAC,Ahmedabad
Vd Rakesh Shukla, GAAC, Ahmedabad

2. INTRODUCTION
•Tetanusisanacuteinfectiousdisease.:
•Alsoknownaslockjaw&8.thdaydiseases.
•Oneamong6killerdiseases.
•Occursthroughwoundcontamination.
Vd Rakesh Shukla, GAAC, Ahmedabad

3. DEFINITION
•Tetanusisanacuteinfectiousdiseasesinducedby
exotoxinofclostridiumtetani&characterizedbyrigidity,
intermittentspasmofthevoluntarymuscles
&convulsions..
•Tetanusoccurswhenawoundbecomesinfectedwith
bacterialspores.
Vd Rakesh Shukla, GAAC, Ahmedabad

4. Vd Rakesh Shukla, GAAC, Ahmedabad

5. AGENT
•Cl.tetaniisagram-positive,anaerobic,sporebearing
&highlyresistantorganism
•Remainsstrictlylocalizedtothesiteofmultiplication
•Produceexotoxin.
1.apowerfulneurotoxins-tetanospasmin-resposiblefor
clinicaldiagnosisbecauseitcausesdisinhibitionof
motorsystemleadingtomusclerigidity
2.ahemolysin-tetanolysin
•Lethaldose-0.1mgfor70kgman.
Vd Rakesh Shukla, GAAC, Ahmedabad

6. PATHOLOGY
•SEQUENCEIS;-
•Introductionofthespores
•Germination
•Elaborationofthetoxins
•bindingtothereceptor
Vd Rakesh Shukla, GAAC, Ahmedabad

7. RESERVOIR OF
INFECTION
•Naturalhabitissoil&dust
•Alsofoundintheintestinesofmanyherbivorous
animalse.g.cattle,horses,goat,
•Excretedintheirfaecesofanimals
Vd Rakesh Shukla, GAAC, Ahmedabad

8. HOST FACTORS
•AGE:Activeage(5-40)
•SEX:Higherincidentsfoundinmales
•OCCUPATION :Agricultureworkersataspecialrisk
becauseofcontactwithsoil
•IMMUNITY:Noageisimmuneunlessprotectedby
previousimmunization.
•Tetanustoxoidseffectiveforseveralyears
Vd Rakesh Shukla, GAAC, Ahmedabad

9. INCUBATOIN PERIOD
•Generallylessthan2weeks
•Alsorangefrom2-60days
•Shorterperiodindicategreaterrisk
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
•Vaguediscomfort
•Painaroundthesiteofinjury&restlessness
•Increasedtoneofmassetermuscle
•dysphagia
•Abdominal&trunkmusclesbecomespastic
•Withprolonged&sustainedspasmleadstomuscular
exhaustion,hypertension&cardiacfailure.
Vd Rakesh Shukla, GAAC, Ahmedabad

12. •Rigidity&spasmofthebackmusclesresultin
hypertensionofspine&neck-opisthotonous
•Grinningexpressionsbroughtaboutbythesustained
contractionoffacialmuscles-Risussardonicus
•Intervalbetweenthefirstsymptom&thefirstconvulsions
iscalled–onsetperiod
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&othersymptomsconfinetopartsnearthesite
ofinjury
•It’samildcourse&endsincompleterecovery
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
•Occurswithin10daysofbirth
•Manifestsasinabilitytosuckthethenipple,irritability&
excessivecrying
•Infectionoftheumbilicalstump
•majorcauseofinfantmortality
Vd Rakesh Shukla, GAAC, Ahmedabad

17. DIAGNOSIS
•Entirelyonclinicalfindings
•Elevatedleukocytecount
•Normalcerebrospinalfluids
•Electromyogramsmayshowcontinuousdischargemotor
units
Vd Rakesh Shukla, GAAC, Ahmedabad

18. DIFFERENTIAL
DIAGNOSIS
•Shouldbedifferentiatedfrom
•Localcauseoftrismus
•Distonia
•meningoencephalitis
•strychninpoisoning
Vd Rakesh Shukla, GAAC, Ahmedabad

19. TREATMENT
•Woundsmustbecleaned
•Neutralizethetoxinsalreadyincirculationbyantitoxins
•GiveATS(antitetanusserum)intravenouslyor
intramuscularly
•Antibioticspenicillium&benzylpenicillin-0.5megaunit6
hourly
Vd Rakesh Shukla, GAAC, Ahmedabad

20. •Convulsioncontrolbydiazepam
•Tracheostomytomaintainthepatencyofairways
•Nutritionalsupply
•Fluidelectrolytebalance
Vd Rakesh Shukla, GAAC, Ahmedabad

21. PREVENTION
oActivelyimmunizeby3doses-
oBoosterdoseevery10years
oActiveimmunizationofpregnantwomen
oPrimarycareofthewounds
oPenicillintherapyreducetherisk
Vd Rakesh Shukla, GAAC, Ahmedabad

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