Clostridium tetani: Clinical manifestations

Clostridium tetani: Clinical manifestations


Infection is acquired by

  • Contamination of wounds with the spores of the bacteria.
  • Not transmitted from person to person , i.e. herd immunity  is not protective
  • The spores or bacteria enter the body through abrasions, wounds, or (in the case of neonates) the umbilical stump.
  • Minimum lethal human dose of exotoxin is 2.5 ng/kg.
  • Seen more often in the summer season and in hot, damp climates with soil rich in organic matter.
  • Wounds contaminated with fecal matter and soil are most prone

May develop in chronic conditions:

  • skin ulcer
  • abscesses
  • gangrene
  • burns
  • frost bite
  • middle ear infection.

Also associated with 

  • surgery
  • abortion
  • childbirth
  • body piercing
  • drug abuse notably skin popping 
  • open fracture etc.

Symptoms

  • Symptoms are due to the effect of toxin.
  • Tetanospasmin (neurotoxin) is responsible for tetanus.
  • Tetanus is characterized by increased muscle tone (muscle spasm) and rigidity.
  • Median time of onset after injury is 7 days.
  • Period of onset in tetanus refers to the time between first symptom to spasm
  • First symptom – 
  • Pain and tingling at the site of inoculation
  • Early signs –
  • Increased tone in masseter muscles called as tismus/lock jaw. 
  • Headache restlessness and irritability                                                       
  • Dysphagia neck muscle spasm
  • Followed by Descending tetanus:
  • Sequential involvement of nerves of head, trunk and extremities
  • Short nerves affected first.
  • Hand and feets relatively spared

Sinus sardonius:

  • Spasms of facial and buccal muscles.       
  • Unimpaired mentation.
  • Increased deep tendon reflex.
  • Opisthotonos (Arched posture)
  • Seizures
  • Respiratory muscle spasm
  • Autonomic dysfunction (sympathetic increase)
  • Sudden cardiac death may occur
  • Neonatal tetanus 
  • usually occurs as generalized form.
  • Local tetanus
  • only the nerves supplying the affected muscles are involved.
  • Cephalic tetanus:
  • Rare form with high mortality
  • May occur after head injury or ear infection.
Exam Question
 

Infection is acquired by

  • Not transmitted from person to person , i.e. herd immunity  is not protective
  • Minimum lethal human dose of exotoxin is 2.5 ng/kg.
  • Seen more often in the summer season and in hot, damp climates with soil rich in organic matter.
  • Wounds contaminated with fecal matter and soil are most prone

Symptoms

  • Symptoms are due to the effect of toxin.
  • Tetanospasmin (neurotoxin) is responsible for tetanus.
  • Median time of onset after injury is 7 days.
  • Period of onset in tetanus refers to the time between first symptom to spasm
  • Sinus sardonius:
  • Spasms of facial and buccal muscles.
Don’t Forget to Solve all the previous Year Question asked on Clostridium tetani: Clinical manifestations

Leave a Reply

%d bloggers like this:
Malcare WordPress Security