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bacteria

anaerobic

gram-positive

spore-forming

found in soil, animal feces

rod-shaped, drumstick like appearance

produces 2 exotoxins: (1)tetanolysin, (2)tetanospasmin (neurotoxin, which causes tetanus)

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caused by exotoxin produced by Clostridium tetani

"often fatal

characterized by generalized rigidity and convulsive spasms of skeletal muscles

etiology discovered in 1884 by Carle and Rattone"

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1. "local (uncommon),

2. cephalic (rare),

3. generalized (most common)"

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"8 days (range, 3-21 days)"

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"Generalized tetanus: descending pattern of trismus (lockjaw), stiffness of the neck, difficulty swallowing, rigidity of abdominal muscles

spasms continue for 3-4 weeks"

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"Laryngospasm

Fractures

Hypertension and/or abnormal heart rhythm

Nosocomial infections

Pulmonary embolism

Aspiration pneumonia

Death"

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"Reservoir

soil and intestine of animals and humans

Transmission

contaminated wounds

tissue injury

Temporal pattern

peak in summer or wet season

Communicability

not contagious"

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Anyone can get it.

"usually enters the body through a wound

anaerobic conditions allow germination of spores and production of toxins

toxin binds in central nervous system

interferes with neurotransmitter release to block inhibitor impulses

leads to unopposed muscle contraction and spasm"

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VACCINATION is the primary form of prevention against tetanus.

Tetanus toxoid immunizations were initially produced in 1924 ("first widely used during World War II").

"Formalin-inactivated tetanus toxin

Schedule

three or four doses plus booster

booster every 10 years

Efficacy

approximately 100%

Duration

approximately 10 years

Should be administered with diphtheria toxoid as DTaP, DT, Td, or Tdap"

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wound cleaning

removal of foreign material

debridement of necrotic tissue

supportive therapy/management of airway clearance during spasms

administration of Tetanus immune globulin (TIG) (or Intravenous immune globulin [IVI] when TIG is unavailable)

"complete recovery may take months"

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https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html