tetanus in children2024/7/23.6435849435.pdf

explains tetanus in children

1. Done by :
Manar Galal
Aisha abdullah
Childhood Tetanus

2. Tetanus is a major cause of mortality in unvaccinated persons and newborns of
unvaccinated mouthers.
Tetanus is not communicable disease .
Definition: it is acute spastic paralytic disease caused by clostridium tetani
(anaerobic gram positive bacillus)
C.tetani spores may be found house dust, faces of animals, contaminate soil and
water, contaminate wound ,umbilical stump in newborn.
The C.tetani produces 2 toxins:
1.TetanospasminNeurotoxic
2.Tetanolysin potentiate the effect of tetanus toxin.
Tetanus in children

3. Types of Clostriduimis more than 11 type but found 4 common types are:
1.C.tetani
2.C.difficile
3.C.botulinum
4.C.perfringens
Tetanus neonatorum.
Generalized tetanus.
Cephalic tetanus.
Localized tetanus.(mild tetanus)
Types of tetanus:

4. Pathogenesis

5. Clinical picture:
Incubation period: 1-14 days.
Tetanus neonatorum:
due to contaminate newborn umbilical stump, the symptoms begin 3-10 days after
birth and pattern is generalized as:
1.Faliurerto suck. 2. excessive crying 3.fever 4. convulsion
pain and spasm or stiffinessat site of injury for few weeks.
that occur in patients who received the antitoxin before.
mortality<1%.
follow head injury or otitis media ,short incubation period1-2 days
involve cranial nerves palsy especially 7
th
nerve.
high mortality rate.
Localized tetanus:
Cephalic tetanus:

6. Generalized tetanus:
spasms precipitated by visual or auditory stimuli.
1.Risus sardonicus: facial muscles spasm.
2.Trismus: difficult mouth opening due to masseter spasm.
3.Laryngeal spasm: stridor and may be suffocation.
4.Opisthotonus: arched back.
5.Tonic seizures: flexed addicted arms and extended
lowers limbs with colonic.

7. Diagnosis:
Clincally: history of wound and typical
spasm, history of unvaccination.
C.B.C and CSF are normal.
Wound culture .
Complication:
Aspiration pneumonia.
pneumothorax.
lung collapse.
tongue laceration.
vertebral fractures.
muscle heamatoma.
DDx:
Tetany.
Bacterial meningitis.
Encephalitis.
Birth trauma.
Epilepsy.
Rabies.

8. Treatment:
surgical management of wound .
keep the patient quiet and in dark room.
I.V fluid and respiratory care.
Diazepam I.V for spasm (0.1-0.3 mg/kg)
Penicillin G (200.000 IU/Kg/d)I.V for 10 days.
Toxin neutralization:
1.tetanus immunoglobulin (3000-6000)IU
2.Anti tetanic serum (50.000-100.000)IU
Prevention:
Active immunization:DTP at 2,4,6,18 months
prevention of tetanus neonatorum:
-Maternal immunization with tetanus toxoid
-if the first pregnancy: first dose at 2 month
second dose between 5-6 month
-If the second preganacy< 5 years take single dose at 8
mounth
-If >5years take 2 doses at 2
nd
and between 5-6 month.

9. Prevention of tetanus after injury:
Major injuryMinorinjuryVaccination
IG
()
T.Toxoid
()
IG
()
T.Toxoid
()
Unknown or less than 3
doses of vaccine
Ifless than 5
th
years
Give him IG
Ifless than 10
th
years
Don’t give him
More than 3 doses
If more than 5
th
years
give him T.toxidand Ig
If morethan 10
th
years
give him T.toxid

10. Thank you