Tetanus Flashcards
an acute illness with muscle spasms or hypertonia in the absence of a more likely diagnosis
Probable Tetanus
an illness occurring in a child who has the normal ability to such and cry in the first 2 days of life but loses this ability between days 3 and 28 of life and become rigid and has spasms
Neonatal tetanus
tetanus occurring during pregnancy or within 6 weeks after the conclusion of pregnancy
Maternal tetanus
characteristics of Clostridium tetani
anaerobic, gram-positive, spore-forming whose spores are highly resilient and can surviec readily in the environment throughout the world
minimum lethal human dose of tetanus exotoxin
2.5 ng/kg
Clinical and pathologic progression of tetanus
Clinical manifestation of tetanus occurs only after tetanus toxin has reached presynaptic inhibitory nerves
First muscle affected by tetanus
Muscles of the face and jaw
Most common initial symptoms of tetanus
trismus (lockjaw), muscle pain and stiffness, backpain,, and difficulty swallowing
most common cause of death in tetanus
Respiratory failure
Diagnosis of tetanus
based on clnical findings
Differential diagnosis for tetanus
Strychnine poisoning
Dystonic reactions to antidopaminergic drugs
Preferred antibiotic therapy
Metronidazole 400 mg rectally or 500 mg IV q6h x 7 days
*penicillin - exacerbate spasms
Managament of tetanus
- Clean entry wound (+debridement of necrotic material to remove anaerobic foci of infection)
- Metronidazole
- Antitoxin -to deactivate any circulating tetanus toxin
- Spasms - benzodiazepine, chlorpromazine, phenobarbital, IV mgso4
Factors associated with poor outcome
WHO recommendation for tetanus vaccination
Primary course of 3 doses in infancy, boosters at 407 and 12-15 years of age, and one booster in adulthood
