Clinical

·
causative : CLOSTRIDIUM TETANI manifestations :

TRISMUS/
·

Lock
↳ anaerobe jaw
Gram + ve
Obligate
,
,

↳ 4 in masseter tone
bacilli with terminal round spore
back pain
Muscle
·
pain , stiffness ,
,

· Drum Stick Appearance difficulty in

swallowing
· NEONATES >
-

difficulty in
feeding
Pathogenesis :

tetanolysin ·
spastic paralysis
virulence
factors [tetanospasmin
·

Y
·
Hand a
feet
>
-

spared
[TS]
neurotosein
·

Deep tendon reflexs >

-

exaggerated
·
It is an
antigenic ,

TS
Complications :

RISUS
↓ SARDONICUS
·

binds
↳
on motor n e r ve grinding appearance
receptors ↳ sustained fascial spasm
POLYSIALOGANGLIOSIDES
·
OpiSTHOTONUS
↓
↳ spasmodic contraction
toxin
internalisation
to head rack back
extending ,
,

↓ ↳ backward arching
transmission
retrograde LAB D :

to GABA , Glycine 1 specimen-tissue from

wound

G neuron
producing .
c Gram staining
bacilli with terminal
terminals ↳ Gram +ve

round spores

↓ .
3 culture : · Robertson cooked meat broth
B
Blood agar
with polymysin
Glycine
·

⑦ of GABA ,

release 4 . Toxin assay

vivo inoculation test
↳ in mouse

H with serum/wrine
Muscle
spastic paralysis ,
prevention :

spasms , hyper reflexia ·

Tetanus toxoid -
Active immunisation

Mode transmission :
↳ Monovalent incubating toxin
of
:

with
formalin Adsorbed on Alum
rusty nails
,
wounds
puncture
·
,

who
↳ combined : DPT vaccine
·

surgery proper asepsis

Tol
·
otitis media Pentavalent
·
Neorates following abortion/Delivery IDPT ,
Hep B ,
Hib)
↳ unhygienic practices
 Primary imm Children Endotracheal intubation
of
·
. ·

TT under National Immuni . . tracheostomy

given
·

> Anti-spasmodic
Diazepans
-

schedule India
of
·

debridement
·
T closes
·

surgical
isolation
↳ 3 closes of pentavalent
·
patient
vaccine birth
at 6
,
10
, 14 Weeks of
↳ 2 booster closes of
DPT at

16-24 Weeks
. 5 Years

↳ Additional Tol closes at

10 16 Years
.

Adult To
if I' not
given
·
: ;

given

prevention after injury :

T/t :

·
Passive immu :

↳ HTIG (Human tetanus

↳ immunoglobulin)
ATS (Anti tetanus Serum)

·
combined immu :

in non-vaccinated ;

close -> one arm

TT 1

> another ar m
ATS/MTIG
-

TT vaccine as schedule
* per

·
Ab- > Metronidazola