TETANUS Flashcards
is an infectious disease caused by Clostridium tetani which produces potent exotoxin with prominent systemic neuromuscular efforts manifested by generalized spasmodic contractions of the skeletal musculator.
Tetanus
INFECTIOUS AGENT
Clostridium tetani
Tetanus is fatal up to 60% of unimmunized persons, usually within________ of onset.
10 days,
When symptoms develop within_________, the prognosis is poor. (Longworth, 2000)
3 days
INCUBATION PERIOD
- 3 days to 3 weeks in adult
- 3 to 30 days in Tetanus Neonatorum.
Anaerobic, gram (+) with round terminal spore with slender body giving a drumstick appearance.
Clostridium tetani
The organism comes in two form, spore forming and the vegetative form.
C. Tetani
The organism releases two types of toxin
- Tetanospasmin
- Tetanolysin
responsible for muscle spasm;
Tetanospasmin
responsible for destruction of RBC.
Tetanolysin
Source of infection
- Animal and human feces.
- The organism are found in the intestinal wall of herbivorous animals, including man.
- Soil and dust.
- Unsterile sutures, pins, rusty materials, scissors
MOT
Normally, the mode of transmission is through punctured wound that is contaminated by dust, soil, or animal excreta containing Cl. Tetanus.
- Rugged traumatic wounds and burns.
- Umbilical stump in newborn especially for babies delivered at home with faulty cord dressing; babies delivered to mothers without Tetanus toxoid immunization.
- Unrecognized wounds (cleaning of the ear with sharp materials)
- Dental extaction, circumcision, ear piercing.
Clinical Manifestation
Neonate
A. Newborn infants have feeding and sucking difficulty.
b. The infant may cry excessively, most of the time voiceless crying.
c. An attempt to suck results in spasm and cyanosis.
d. There is fever due to infection and dehydration.
e. The jaw becomes so stiff that the baby cannot suck or swallow.
f. Tonic and rigid muscular contraction, spasm or convulsion provoked by stimuli.
g. Mild, short, voiceless cry.
h. Cyanosis and pallor
i. May end with flaccidity, exhaustion, and finally, death.
MANIFESTATIONS OF OLDER. CHILDREN AND ADULT
If tetanus remains localized, signs of onset are spasm and increased muscle tone near the wound.
MANIFESTATIONS OF OLDER. CHILDREN AND ADULT
If it becomes systemic or genaralized, indications include:
- Hypertonicity, hyperactive tendon reflexes, tachycardia, profuse sweating, low grade fever, and painful involuntary muscle contraction.
- Neck and facial muscle rigidity. (trismus)
- Grinning expression (risus sardonicus) – considered as pathognomonic to the disease
- Board-likeadbomen/abdominalrigidity
- Opisthotonos
- Intermittent tonic convulsion lasting for several minutes which may result in cyanosis and sudden death due to asphyxiation.
– considered as pathognomonic to the disease
Grinning expression (risus sardonicus)
Neck and facial muscle rigidity
Trismus
type of abnormal posture where the back becomes extremely arched due to muscle spasms
Opisthotonos
In severe cases,_______ followed by the accumulation of secretions in the lower airway resulting to _______due too involvement of respiratory muscles.
laryngospasm, respiratory distress
may occur during severe spasm, yielding to coma and death.
Fracture of the vertebra
In mild cases, after a period of weeks, spasm gradually diminishes in frequency and severity with__________ being the last symptom to disappear.
trismus
In fatal cases, death is usually occurs during the first ________ of the disease.
10 days
Complications
- Uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
- Broken bones (fractures)
- Septicemia
- Infections gotten by a patient during a hospital visit (hospital-acquired infections)
- Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal)
Modalities of Treatment:
Specific Within_______ after a punctured wound, the patient should receive ATS, TAT, or TIG especially if the patient does not have any previous immunization.
72 hours
