Tetanus

 
Tetanus is an infection of the nervous system caused by the Clostridium tetani bacteria.

What is going on in the body?

The bacteria that cause tetanus live in the soil. They are also found in animal intestines and human feces. Tetanus occurs when wounds or an infant's umbilical cord are contaminated with the bacteria. The bacteria then multiply and produce a toxin, which affects the nervous system. The toxin travels through the nerves to the brain and spinal cord.

What are the signs and symptoms of the infection?

Symptoms of tetanus usually begin 5 to 10 days after a wound or umbilical cord has been infected. However, the symptoms may occur as early as 2 days and as late as 50 days after exposure. The onset occurs slowly over a few days to a week.

Muscle spasms start out in a mild fashion in one specific part of the body. The most frequent symptom is a stiff jaw. This is caused by spasm of the muscle that closes the mouth. This accounts for the disease's familiar name "lockjaw." The spasms may then become severe and spread throughout the body.

Other symptoms of tetanus include the following: · arrhythmias, or irregular heartbeats · coma · difficulty breathing · difficulty swallowing · high blood pressure · irritability · neck pain or stiffness · restlessness · seizures

What are the causes and risks of the infection?

Tetanus is caused by a toxin made by the bacteria Clostridium tetani. The bacteria are generally introduced into the body through wounds in the skin. The risk of tetanus increases with deep puncture wounds infected by dirt or feces. The bacteria can also be introduced through the umbilical cord of a newborn.

Common sources of tetanus infection include the following: · animal bites · burns · chronic otitis media, or infections of the middle ear · crush injuries · dental procedures · elective surgical abortion · frostbite wounds · human bites · puncture wounds · surgery

What can be done to prevent the infection?

The tetanus vaccine can prevent this disease. This vaccine is usually combined with the diphtheria and pertussis vaccine in the DPT vaccination. It is initially given in early childhood. Booster shots are needed every 5 to 10 years to maintain immunity.

For high-risk wounds in a person who has never been immunized or has not had the complete series of injections, tetanus immune globulin can be used to prevent tetanus.

How is the infection diagnosed?

Diagnosis of tetanus begins with a medical history and physical examination.

What are the long-term effects of the infection?

Aspiration pneumonia, caused by inhaling stomach contents, is a serious complication.

What are the risks to others?

Tetanus is not contagious from person to person.

What are the treatments for the infection?

The goals of tetanus treatment are to eliminate the source of toxin and prevent muscle spasms. Treatment of tetanus includes the following: · antibiotics, such as penicillin, doxycycline, and metronidazole · anticonvulsants, such as diazepam and phenobarbital · drainage and cleaning of infected wounds · muscle relaxants, such as dantrium and dantrolene · a quiet, dark environment to minimize muscle spasm · tetanus immune globulin, to decrease the immune response to the bacteria · use of a ventilator, or artificial breathing machine

What are the side effects of the treatments?

Medicines used to treat tetanus can cause stomach upset or allergic reactions. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.

What happens after treatment for the infection?

The mortality rate from tetanus is about 25% in the United States and 50% worldwide. Most people recover from tetanus completely. Recovery can take from 2 to 4 months. Some individuals have low muscle tone after recovery.

How is the infection monitored?

Individuals with tetanus are generally treated in the intensive care unit. After discharge, the person will have periodic visits with the healthcare provider. Any new or worsening symptoms should be reported to the provider.

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