Tetanus

Acute disease caused by neurotoxins from the bacterium Clostridium tetani

Aetiology

  • C. tetani toxin

Pathophysiology

  • C. tetani spores found in soil, enter the body through broken skin
  • Incubation period - 4 days to several weaks
  • Toxin binds to inhibitory neurons, preventing release of inhibitory neurotransmitters → widespread activation of motor neurons and spasming of muscles throughout the body

Clinical presentation

  • Trismus (lock jaw)
  • Risus sardonicus
  • Autonomic instability

Investigations

  • Culture - anaerobic gram positive with terminal spore

Management

  • Surgical debridement
  • Antitoxin, booster vaccination
  • Supportive measures (e.g. benzodiasapines, beta blockers)
  • Antibiotics 7-10 days

Prevention

  • Routine vaccination
  • Wound management