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Tetanus

 

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Tetanus is a neuralgic disorder, characterised by increased muscle tension and spasms (Trismus). The disease is caused by a bacteria called clostridium tetani. This organism is foundin soil and in animal feces. This disease is commonin rural areas of India where soil is cultivated. Before immunizations (vaccines, or shots that are given to help the body fight certain illnesses) were available, neonatal tetanus was a common cause of newborn death because the disease is almost always fatal in infants. Prior to immunizations, neonatal tetanus was much more common in the United States. Now, routine immunizations for tetanus produce antibodies that mothers pass to their unborn babies. These maternal antibodies and sanitary cord-care techniques have made newborn tetanus very rare in developed countries. Tetanus may be fatal despite treatment. The disease is rare in the United States, with less than 100 cases of tetanus reported annually.

Tetanus in the unimmunised follows an acute injury, open wound, lacerations and abrasions. In developing countries of Africa, Asia, and South America, tetanus is far more common. Because of improved surgical procedures and techniques for cutting the umbilical cord, however, newborn tetanus is now rare in developed countries. Starting at 2 months of age, all babies in the United States are routinely vaccinated against tetanus. If deposited in a wound, the bacteria can produce a toxin that interferes with the nerves controlling your muscles. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form.

Tetanus injury in most cases is trivial. All age groups are involved. Wounds may get contaminated with the spores of the organism. The spores germinate within the wound and toxin is produced.This toxin binds to the peripheral nerves and is transported thereafter to the spinal cordand the brain.

Tetanus is a medical term indicating a prolonged contraction of skeletal muscle fibers. Tetanus is a serious bacterial disease that leads to stiffness of your jaw muscles and other muscles. It typically arises from a skin wound that becomes contaminated by a bacterium called Clostridium tetani , which is often found in soil. A cut, puncture wound, laceration or other wound can lead to a tetanus infection and toxin production if you don't have immunity. It can also travel to other parts of the body through the bloodstream and lymph system. As it circulates more widely, the toxin interferes with the normal activity of nerves throughout the body, leading to generalized muscle spasms. These bacteria produce the toxin (poison), tetanospasmin, which is responsible for causing tetanus. This poison affects the place where nerves and muscles meet.

Tetanus is a disease caused by the toxin of the bacterium Clostridium tetani that affects the central nervous system , sometimes resulting in death. Infection usually originates from a contaminated wound, often a cut or deep puncture wound. Once the bacteria are in the body, they produce a neurotoxin (a protein that acts as a poison to the body's nervous system) known as tetanospasmin that causes muscle spasms. Common symptoms are muscle spasms in the jaw (hence the common name lockjaw ), followed by difficulty swallowing and general muscle stiffness of other parts of the body In the United States, because of widespread immunization and careful wound care, the annual number of cases among children is between 50-100 cases.

Causes of Tetanus

The common Causes of Tetanus :

  • Tetanus can occur in burn victims; in patients receiving intramuscular injections; in persons obtaining a tattoo; and in persons with frostbite, dental infections (eg, periodontal abscesses), penetrating eye injuries, and umbilical stump infections.
  • Tetanus has been reported after tooth extractions, root canal therapy, and intraoral soft tissue trauma.
  • The effect of the toxin on your nerves can cause muscle stiffness and spasms the major signs of tetanus.
  • The wound may go unnoticed, and the infection may not seem very severe but the bacteria releases a poison called a neurotoxin that attacks the nervous system and causes problems such as muscle spasm.
  • Other reported risk factors include diabetes, chronic wounds (eg, skin ulcers, abscesses, gangrene), parenteral drug abuse, and recent surgery (4% of US cases).
  • Tetanus may develop in people who are not immunized against it or in people who have failed to maintain adequate immunity with active booster doses of vaccine.
  • In unfavourable circumstances to the growth of the organism, spores are formed and these remain dormant for years in the soil.

Symptoms of Tetanus

Some common Symptoms of Tetanus :

  • Tetanic seizures (painful, powerful bursts of muscle contraction )
  • Spasms and tightening of the jaw muscle ("lockjaw")
  • Irritability
  • Stiffness of your jaw, neck and other muscles
  • Fever
  • Swallowing difficulty
  • Arching of the back and neck
  • Abdominal muscles
  • Sweating
  • Abnormal heart rate and blood pressure

Treatment of Tetanus

Here is the list of the methods for treating Tetanus :

  • Give penicillin to kill C . tetani (other antibiotics such as clindamycin, erythromycin, or metronidazole can be used in patients who are allergic to penicillin).
  • Remove and destroy the source of the toxin through surgical exploration and cleaning of the wound (debridement).
  • Attempting endotracheal intubation may induce severe reflex laryngospasm; prepare for emergency surgical airway control. Rapid sequence intubation techniques (eg, with succinylcholine) are recommended to avoid this complication
  • Apply direct pressure to the site of bleeding to help minimize blood loss.
  • Muscle spasms can be treated with muscle relaxants such as diazepam.
  • Bedrest with a nonstimulating environment (dim light, reduced noise, and stable temperature) may be recommended.
  • Apply a clean and dry cloth to stop or minimize bleeding.
  • Remove and destroy the source of the toxin through surgical exploration and cleaning of the wound (debridement).
  • Sedation may be necessary to keep the affected person calm.