Tetanus

Tetanus is an acute, often fatal, disease caused by an
exotoxin produced by the bacterium Clostridium tetani. It is
characterized by generalized rigidity and convulsive spasms
of skeletal muscles. The muscle stiffness usually involves the
jaw (lockjaw) and neck and then becomes generalized.
Although records from antiquity (5th century BCE) contain
clinical descriptions of tetanus, it was Carle and Rattone
in 1884 who first produced tetanus in animals by injecting
them with pus from a fatal human tetanus case. During
the same year, Nicolaier produced tetanus in animals by
injecting them with samples of soil. In 1889, Kitasato
isolated the organism from a human victim, showed that it
produced disease when injected into animals, and reported
that the toxin could be neutralized by specific antibodies. In
1897, Nocard demonstrated the protective effect of passively
transferred antitoxin, and passive immunization in humans
was used for treatment and prophylaxis during World War I.
A method for inactivating tetanus toxin with formaldehyde
was developed by Ramon in the early 1920’s which led to
the development of tetanus toxoid by Descombey in 1924.
It was first widely used during World War II.



Brief Description: 

Tetanus is an acute, often fatal
disease caused by an exotoxin produced by the
anaerobic organism C. tetani in a contaminated
wound.  Increased muscle rigidity and severe muscle
spasms characterize tetanus.  The muscle stiffness
usually first involves the jaw (lockjaw) and neck, and
later becomes generalized.  Muscle spasms may
continue for 3-4 weeks or more.  Other symptoms
include fever, sweating, elevated blood pressure, and
rapid heart rate.



Mode of Transmission: 

Tetanus spores are introduced into the body through: (1) puncture wounds;
(2) lacerations, burns, trivial or unnoticed wounds in
which fecally-contaminated soil containing C. tetani
spores penetrates body tissues; or (3) by injected
contaminated street drugs.



Treatment: 


Tetanus Immune

• Globulin (TIG) IM, in doses of 3,000-6,000 IU. 

 The wound
should be properly cleaned, debrided, and
excised if necessary.

•  Metronidazole (30 mg/kg per day, given at 6-hour intervals)

 is the antibiotic of choice and should be given for 7-14
days.  Active immunization should be initiated concurrently with therapy.  Tetanus clinical disease
does not confer immunity because of the small
amount of toxin required to produce illness.

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