Neurological Infection: Tetanus

Question 1

Main causative agent?

Answer 1

Clostridium tetani (part of the Clostrium family which includes botulism, perfringens [gas gangrene
 ] and difficile)

Question 2

Where is the microbe C. tetani mostly found?

Answer 2

• Soil
• Splinters
• Rusty nails
• Intestine of humans and animals

Question 3

Pathophysiology?

Answer 3

• toxin block GABA presynaptic nerves leading loss of inhibition, hence sustained muscle contraction called tetany

Question 4

Clinical Features?

Answer 4

• Tetanic Spasms begin in jaw called –> locked jaw (trismus)
• Facial grimance –> risus sardonicus
• Can affect large muscle groups: neck, back (opisthotonus>arched back), abdomen, chest muscles and buttock.

Question 5

Treatment?

Answer 5

• 3 steps for mild tetanus
  
  • Debride wound to rid of toxin
  • IV tetanus immunoglobulin
  • IV metronidazole (since its an anaerobe)