TETANUS

Prepared by
Dr. BP CHAYRASIYA
Tetanus
Tetanus is a bacterial disease caused by the neurotoxin tetanospasmin
elaborated by clostridium tetani.

Morphology
a. Obligate anaerobic bacteria
b. Gram positive
c. Rod shape
d. Spore forming
e. Non-capsulated

Incubation period: 5 days to 15 weeks.

Average 8-12 days
Mode of Transmission
a. Skin abrasion
b.Unsterile surgery, intera-uterine death
c. Unsterile instruments to cut umbilical cord
d.Animal bites
e. Human bites
f. Punctured wound
g.Bowel surgery
h.Otitis media
i. Accidents
 Pathogenesis
Tetanus-neurotoxin

Presynaptic membrane of neuromuscular junction

Toxin internalize and transported through axon (retrograde way) reaches to

CNS
Selectively binds with inhibitory neurons

It cleaves(seperate) vesicle associated membrane protein

(synaptobrevin)
Inhibition of membrane fusion of vasicle

Blocking of neurotransmitter muscle( GABA – Gamma Amino Butyric acid and

Glycrine)
Clinical Manifestation
a. Muscles of face and jaw are commonly involved
b.First symptom- increase muscle tone

leading to trismus or look jaw followed by muscle pain and

stiffness, back pain and difficulty in swallowing

Complications
a. Resus sardonicus – abnormal sustained spasm of facial muscle
b. Opisthotonos position – abnormal posture of the body due to
generalized spastic contraction of the extensor muscle
Investigation
a.Diagnosis is clinical
b.Lab diagnosis – specimen – tissue bits from
wound
- gram staining
- culture – 37 degree celsius –
swarming growth
Immunization of children
DPT :-given at 6,10 and 14 weeks of age
Followed by booster dose at 16-24weeks and 5 years
Followed by 2 additional dose TT at 10 year and 16 years
Immunization of adult
TT -2 dose at 1 month
Internal followed by 2 booster dose at 1 year and 6 year
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