Tetanus

Tetanus - Clostridium tetani

Ø  Gram positive bacillus, anaerobic, endospores, common in soil & GI tract animals

Ø  Virulence:  Powerful neurotoxin - blocks neurotransmitter inhibitor cholinesterase

Ø  P/E:  Endospores introduced deep into tissue wound (puncture wound)

Ø  Disease:  Incubation period. 4 days. - 2 week.  Endospores germinate ® bacteria multiply at site, remain localized producing little or no inflammation ® secretes neurotoxin ® enters bloodstream ® CNS where interferes with cholinesterase ® causes tonic contractions, painful spasms of muscles.

Ø  Onset:  Headache, stiff neck, ­ fever, chills.  Spasms begin in muscles of face (causes difficulty in opening mouth) ® neck ® back ® chest ® abdomen ® extremities. Spasms can break bones, cause body contortions.  Involvement of respiratory, cardiac muscles ® convulsions ® coma ® death.

Vaccine: tetanus toxoid (TT) DPT toxoid .Anti tetanus antiserum also available - only neutralizes toxin in bloodstream.