December 22 21:50 2019 Print This Article

Tetanus is a medical term indicating a prolonged contraction of skeletal muscle fibers. Another name for tetanus is lockjaw. It is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles.Tetanus is preventable through immunization. Because of widespread use of tetanus vaccine, the condition is now rare.

It typically arises from a skin wound that becomes contaminated by a bacterium called Clostridium tetani, which is often found in soil.Despite widespread immunization of infants and children in the United States since the 1940s, tetanus still occurs in the United States. Currently, tetanus is a severe disease primarily of older adults who are unvaccinated or inadequately vaccinated. People get tetanus when spores of the tetanus bacteria enter the body through an open wound and produce a powerful nerve poison.

Neonatal (newborn) tetanus can occur when a baby is delivered in unsanitary conditions, especially if the cut umbilical cord is contaminated after the baby is born. Infection usually originates from a contaminated wound, often a cut or deep puncture wound. Tetanus is the primary symptom caused by the neurotoxin tetanospasmin which is produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani.

Clostridium tetani, an obligate anaerobic gram-positive bacillus, causes tetanus. This bacterium is nonencapsulated and forms spores, which are resistant to heat, desiccation, and disinfectants. The toxin first affects nerves controlling the muscles near the wound. It can also travel to other parts of the body through the bloodstream and lymph system. In the United States, most cases of tetanus follow a cut or deep puncture injury, such as a wound caused by stepping on a nail.

Causes of Tetanus

The comman causes of Tetanus include the following:

  • Tetanus is caused by a toxin (poison) produced by spores of the bacterium Clostridium tetani.
  • In 73% of patients with tetanus in the United States, tetanus occurred after an acute injury, including puncture wounds (50%), lacerations (33%), and abrasions (9%).
  • Other reported risk factors include diabetes, chronic wounds (eg, skin ulcers, abscesses, gangrene), parenteral drug abuse, and recent surgery (4% of US cases).
  • The spores are in soil, dust, and animal waste and can survive there for many years. These spores are resistant to extremes of temperature.
  • Approximately 50% of adults older than 50 years are nonimmune because they never were vaccinated or do not receive appropriate booster doses.
  • The active cells release 3 toxins, and 1 of these toxins is responsible for the disease. This toxin is called tetanospasmin.

Symptoms of Tetanus

Some sign and symptoms of Tetanus include the following:

  • Spasms and tightening of the jaw muscle (“lockjaw”).
  • Muscular irritability.
  • Tetanic seizures (painful, powerful bursts of muscle contraction ).
  • Drooling.
  • Uncontrolled urination and/or defecation.
  • In localized tetanus, muscle spasms occur at or near the site of your injury. This condition rarely progresses to generalized tetanus.
  • Irritability.
  • Stiffness of your jaw, neck and other muscles.
  • Fever.
  • In cephalic tetanus, in addition to lockjaw, weakness of at least 1 other facial muscle occurs. In two-thirds of these cases, generalized tetanus will develop.

Treatment of Tetanus

Here is list of the methods for treating Tetanus:

  • Control and reverse the tetany with antitoxin (tetanus immune globulin).
  • Give penicillin to kill C. tetani (other antibiotics such as clindamycin, erythromycin, or metronidazole can be used in patients who are allergic to penicillin).
  • Admit patients to the ICU. Due to risk of reflex spasms, maintain a dark and quiet environment for the patient. Avoid unnecessary procedures and manipulations.
  • In localized tetanus, muscle spasms occur at or near the site of your injury. This condition rarely progresses to generalized tetanus.
  • Severe cases can involve spasms of the vocal cords or muscles involved in breathing.
  • Bedrest with a nonstimulating environment (dim light, reduced noise, and stable temperature) may be recommended.