Tetanus: Difference between revisions
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Tetanus is an infection caused by bacteria called '''[[Clostridium tetani]]'''. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions. Another name for tetanus is | {{SI}} | ||
{{Infobox medical condition | |||
| name = Tetanus | |||
| image = [[File:Opisthotonus_in_a_patient_suffering_from_tetanus_-_Painting_by_Sir_Charles_Bell_-_1809.jpg|250px]] | |||
| caption = Opisthotonus in a patient suffering from tetanus | |||
| field = [[Infectious disease]] | |||
| symptoms = [[Muscle spasms]], [[fever]], [[sweating]], [[headache]], [[trouble swallowing]], [[high blood pressure]], [[fast heart rate]] | |||
| complications = [[Laryngospasm]], [[fractures]], [[hypertension]], [[pulmonary embolism]], [[aspiration pneumonia]] | |||
| onset = 3 to 21 days after exposure | |||
| duration = Weeks to months | |||
| causes = [[Clostridium tetani]] | |||
| risks = [[Wounds]], [[animal bites]], [[injection drug use]], [[burns]], [[umbilical stump infection]] | |||
| diagnosis = Based on [[symptoms]] and [[history of exposure]] | |||
| prevention = [[Tetanus vaccine]] | |||
| treatment = [[Tetanus immune globulin]], [[antibiotics]], [[muscle relaxants]], [[mechanical ventilation]] | |||
| prognosis = 10% mortality with treatment | |||
| frequency = 209,000 cases worldwide (2015) | |||
}} | |||
Tetanus is an infection caused by bacteria called '''[[Clostridium tetani]]'''. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions. Another name for tetanus is '''lockjaw”. It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow. | |||
Tetanus is different from other vaccine-preventable diseases because it does not spread from person to person. | Tetanus is different from other vaccine-preventable diseases because it does not spread from person to person. | ||
[[File:Neonatal tetanus 6374.jpg|thumb]] | [[File:Neonatal tetanus 6374.jpg|left|thumb]] | ||
[[File:Tetanus Neurotoxin.png|thumb]] | [[File:Tetanus Neurotoxin.png|left|thumb]] | ||
<youtube> | <youtube> | ||
title='''{{PAGENAME}}''' | title='''{{PAGENAME}}''' | ||
| Line 14: | Line 31: | ||
height=600 | height=600 | ||
</youtube> | </youtube> | ||
== '''Cause''' == | == '''Cause''' == | ||
Tetanus is an [[infection]] caused by a [[bacterium]] called '''[[Clostridium tetani]]'''. Spores of tetanus bacteria are everywhere in the environment, including soil, dust, and manure. The spores develop into bacteria when they enter the body. | Tetanus is an [[infection]] caused by a [[bacterium]] called '''[[Clostridium tetani]]'''. Spores of tetanus bacteria are everywhere in the environment, including soil, dust, and manure. The spores develop into bacteria when they enter the body. | ||
== '''Transmission''' == | == '''Transmission''' == | ||
The spores can get into the body through broken skin, usually through injuries from contaminated objects. Tetanus bacteria are more likely to infect certain breaks in the skin. These include: | The spores can get into the body through broken skin, usually through injuries from contaminated objects. Tetanus bacteria are more likely to infect certain breaks in the skin. These include: | ||
| Line 33: | Line 48: | ||
* Intravenous (IV) drug use | * Intravenous (IV) drug use | ||
* Intramuscular injections (shots given in a muscle) | * Intramuscular injections (shots given in a muscle) | ||
== '''Pathogenesis''' == | == '''Pathogenesis''' == | ||
Clostridium tetani (C. tetani) spores usually enter the body through a wound or breach in the skin. Neonatal tetanus usually occurs because of umbilical stump infections. In the presence of anaerobic conditions, the spores germinate. The bacteria produce very potent [[toxins]], most of which the blood stream and lymphatic system disseminate through the body. Toxins act at several sites within the central nervous system, including peripheral motor end plates, spinal cord, and brain, as well as in the sympathetic nervous system. Tetanus toxin causes the typical clinical manifestations of tetanus by interfering with the release of [[neurotransmitters]] and blocking inhibitor impulses. This leads to unopposed muscle contraction and [[spasm]]. [[Seizures]] may occur, and the autonomic nervous system may also be affected. | Clostridium tetani (C. tetani) spores usually enter the body through a wound or breach in the skin. Neonatal tetanus usually occurs because of umbilical stump infections. In the presence of anaerobic conditions, the spores germinate. The bacteria produce very potent [[toxins]], most of which the blood stream and lymphatic system disseminate through the body. Toxins act at several sites within the central nervous system, including peripheral motor end plates, spinal cord, and brain, as well as in the sympathetic nervous system. Tetanus toxin causes the typical clinical manifestations of tetanus by interfering with the release of [[neurotransmitters]] and blocking inhibitor impulses. This leads to unopposed muscle contraction and [[spasm]]. [[Seizures]] may occur, and the autonomic nervous system may also be affected. | ||
== '''Types''' == | == '''Types''' == | ||
There are three clinical forms of tetanus: | There are three clinical forms of tetanus: | ||
| Line 42: | Line 55: | ||
# Localized | # Localized | ||
# Cephalic | # Cephalic | ||
'''Generalized Tetanus''' | '''Generalized Tetanus''' | ||
Generalized tetanus is the most common form, accounting for more than 80% of cases. The most common initial sign is [[spasm]] of the muscles of the jaw or | Generalized tetanus is the most common form, accounting for more than 80% of cases. The most common initial sign is [[spasm]] of the muscles of the jaw or '''lockjaw”. Other signs may follow '''lockjaw.'''These can include painful spasms in other muscle groups in the neck, trunk, and extremities and generalized, seizure-like activity or [[convulsions]] in severe cases. Nervous system abnormalities, as well as a variety of complications related to severe spasm and prolonged hospitalization, can accompany generalized tetanus. The clinical course of generalized tetanus is variable and depends on the | ||
* Degree of prior immunity | * Degree of prior immunity | ||
* Amount of toxin present | * Amount of toxin present | ||
* Age and general health of the patient | * Age and general health of the patient | ||
* Even with modern intensive care, generalized tetanus is associated with death rates of 10% to 20%. | * Even with modern intensive care, generalized tetanus is associated with death rates of 10% to 20%. | ||
'''Localized Tetanus''' | '''Localized Tetanus''' | ||
Localized tetanus is an unusual form of the disease consisting of muscle [[spasms]] in a confined area close to the site of the injury. Although localized tetanus often occurs in people with partial immunity and is usually mild, progression to generalized tetanus can occur. | Localized tetanus is an unusual form of the disease consisting of muscle [[spasms]] in a confined area close to the site of the injury. Although localized tetanus often occurs in people with partial immunity and is usually mild, progression to generalized tetanus can occur. | ||
'''Cephalic Tetanus''' | '''Cephalic Tetanus''' | ||
The rarest form, cephalic tetanus, is associated with [[lesion]]s of the head or face and may also be associated with otitis media. The incubation period is short, usually 1 to 2 days. Unlike generalized and localized tetanus, cephalic tetanus results in flaccid cranial nerve palsies rather than spasm. Spasm of the jaw muscles may also be present. Like localized tetanus, cephalic tetanus can progress to the generalized form. | The rarest form, cephalic tetanus, is associated with [[lesion]]s of the head or face and may also be associated with otitis media. The incubation period is short, usually 1 to 2 days. Unlike generalized and localized tetanus, cephalic tetanus results in flaccid cranial nerve palsies rather than spasm. Spasm of the jaw muscles may also be present. Like localized tetanus, cephalic tetanus can progress to the generalized form. | ||
== '''Symptoms''' == | == '''Symptoms''' == | ||
People often call tetanus | People often call tetanus '''lockjaw'''because one of the most common signs of this infection is tightening of the jaw muscles. Tetanus infection can lead to serious health problems, including being unable to open the mouth and having trouble swallowing and breathing. | ||
Symptoms of tetanus include: | Symptoms of tetanus include: | ||
* The first sign is most commonly spasms of the muscles of the jaw, or | * The first sign is most commonly spasms of the muscles of the jaw, or '''lockjaw.” | ||
* Jaw cramping | * Jaw cramping | ||
* Sudden, involuntary muscle tightening (muscle spasms) | * Sudden, involuntary muscle tightening (muscle spasms) — often in the stomach | ||
* Painful muscle stiffness all over the body | * Painful muscle stiffness all over the body | ||
* Trouble swallowing | * Trouble swallowing | ||
| Line 68: | Line 77: | ||
* Fever and sweating | * Fever and sweating | ||
* Changes in blood pressure and heart rate. | * Changes in blood pressure and heart rate. | ||
==Complications== | ==Complications== | ||
* Serious health problems that can happen because of tetanus include: | * Serious health problems that can happen because of tetanus include: | ||
| Line 77: | Line 85: | ||
* Pneumonia, a lung infection, that develops by breathing in foreign materials (aspiration pneumonia) | * Pneumonia, a lung infection, that develops by breathing in foreign materials (aspiration pneumonia) | ||
* Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal) | * Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal) | ||
== '''Diagnosis''' == | == '''Diagnosis''' == | ||
Doctors can diagnose tetanus by examining the patient and looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus. | Doctors can diagnose tetanus by examining the patient and looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus. | ||
== '''Treatment''' == | == '''Treatment''' == | ||
Tetanus is a medical emergency requiring: | Tetanus is a medical emergency requiring: | ||
| Line 90: | Line 96: | ||
* Tetanus vaccination | * Tetanus vaccination | ||
* Depending on how serious the infection is, a machine to help you breathe may be required. | * Depending on how serious the infection is, a machine to help you breathe may be required. | ||
==Treatment of tetanus cases with TIG== | ==Treatment of tetanus cases with TIG== | ||
* Medical experts recommend a single dose of human TIG for treatment of persons with tetanus. Researchers have not established the optimal therapeutic dose. However, experts recommend 500 international units (IU), which appears to be as effective as higher doses ranging from 3,000 to 6,000 IU and causes less discomfort. | * Medical experts recommend a single dose of human TIG for treatment of persons with tetanus. Researchers have not established the optimal therapeutic dose. However, experts recommend 500 international units (IU), which appears to be as effective as higher doses ranging from 3,000 to 6,000 IU and causes less discomfort. | ||
* If TIG is not available, clinicians can use IGIV at a dose of 200 to 400 milligrams per kilogram (mg/kg). However, the Food and Drug Administration has not approved IGIV for this use. In addition, anti-tetanus antibody content varies from lot to lot. | * If TIG is not available, clinicians can use IGIV at a dose of 200 to 400 milligrams per kilogram (mg/kg). However, the Food and Drug Administration has not approved IGIV for this use. In addition, anti-tetanus antibody content varies from lot to lot. | ||
'''Vaccination during Recovery''' | '''Vaccination during Recovery''' | ||
Tetanus disease does not result in tetanus immunity. Clinicians should begin or continue active immunization with a tetanus toxoid-containing vaccine as soon as the | Tetanus disease does not result in tetanus immunity. Clinicians should begin or continue active immunization with a tetanus toxoid-containing vaccine as soon as the person’s condition has stabilized. | ||
== '''Prevention''' == | == '''Prevention''' == | ||
Vaccination and good wound care are important to help prevent tetanus infection. | Vaccination and good wound care are important to help prevent tetanus infection. | ||
'''Vaccination''' | '''Vaccination''' | ||
Being up to date with your tetanus vaccine is the best tool to prevent tetanus.Protection from vaccines, as well as a prior infection, do not last a lifetime. This means that if you had tetanus or got the vaccine before, you still need to get the vaccine regularly to keep a high level of protection against this serious disease. | Being up to date with your tetanus vaccine is the best tool to prevent tetanus.Protection from vaccines, as well as a prior infection, do not last a lifetime. This means that if you had tetanus or got the vaccine before, you still need to get the vaccine regularly to keep a high level of protection against this serious disease. | ||
Several vaccines protect against tetanus, all of which also protect against other diseases: | Several vaccines protect against tetanus, all of which also protect against other diseases: | ||
* DTaP protects against [[diphtheria]], [[tetanus]], and [[pertussis]] (whooping cough) | * DTaP protects against [[diphtheria]], [[tetanus]], and [[pertussis]] (whooping cough) | ||
| Line 110: | Line 110: | ||
* Tdap protects against tetanus, diphtheria, and pertussis | * Tdap protects against tetanus, diphtheria, and pertussis | ||
* Td protects against tetanus and diphtheria | * Td protects against tetanus and diphtheria | ||
'''Good Wound Care''' | '''Good Wound Care''' | ||
Immediate and good wound care can also help prevent infection. | Immediate and good wound care can also help prevent infection. | ||
* | * Don’t delay first aid of even minor, non-infected wounds like blisters, scrapes, or any break in the skin. | ||
* Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible. | * Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible. | ||
== External links == | == External links == | ||
* [https://www.cdc.gov/tetanus/index.html CDC tetanus page] | * [https://www.cdc.gov/tetanus/index.html CDC tetanus page] | ||
Revision as of 21:04, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Tetanus | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Muscle spasms, fever, sweating, headache, trouble swallowing, high blood pressure, fast heart rate |
| Complications | Laryngospasm, fractures, hypertension, pulmonary embolism, aspiration pneumonia |
| Onset | 3 to 21 days after exposure |
| Duration | Weeks to months |
| Types | N/A |
| Causes | Clostridium tetani |
| Risks | Wounds, animal bites, injection drug use, burns, umbilical stump infection |
| Diagnosis | Based on symptoms and history of exposure |
| Differential diagnosis | N/A |
| Prevention | Tetanus vaccine |
| Treatment | Tetanus immune globulin, antibiotics, muscle relaxants, mechanical ventilation |
| Medication | N/A |
| Prognosis | 10% mortality with treatment |
| Frequency | 209,000 cases worldwide (2015) |
| Deaths | N/A |
Tetanus is an infection caused by bacteria called Clostridium tetani. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions. Another name for tetanus is lockjaw”. It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow.
Tetanus is different from other vaccine-preventable diseases because it does not spread from person to person.
Cause
Tetanus is an infection caused by a bacterium called Clostridium tetani. Spores of tetanus bacteria are everywhere in the environment, including soil, dust, and manure. The spores develop into bacteria when they enter the body.
Transmission
The spores can get into the body through broken skin, usually through injuries from contaminated objects. Tetanus bacteria are more likely to infect certain breaks in the skin. These include:
- Wounds contaminated with dirt, poop (feces), or spit (saliva)
- Wounds caused by an object puncturing the skin (puncture wounds), like a nail or needle
- Burns
- Crush injuries
- Injuries with dead tissue
- Clean superficial wounds (when only the topmost layer of skin is scraped off)
- Surgical procedures
- Insect bites
- Dental infections
- Compound fractures (a break in the bone where it is exposed)
- Chronic sores and infections
- Intravenous (IV) drug use
- Intramuscular injections (shots given in a muscle)
Pathogenesis
Clostridium tetani (C. tetani) spores usually enter the body through a wound or breach in the skin. Neonatal tetanus usually occurs because of umbilical stump infections. In the presence of anaerobic conditions, the spores germinate. The bacteria produce very potent toxins, most of which the blood stream and lymphatic system disseminate through the body. Toxins act at several sites within the central nervous system, including peripheral motor end plates, spinal cord, and brain, as well as in the sympathetic nervous system. Tetanus toxin causes the typical clinical manifestations of tetanus by interfering with the release of neurotransmitters and blocking inhibitor impulses. This leads to unopposed muscle contraction and spasm. Seizures may occur, and the autonomic nervous system may also be affected.
Types
There are three clinical forms of tetanus:
- Generalized
- Localized
- Cephalic
Generalized Tetanus Generalized tetanus is the most common form, accounting for more than 80% of cases. The most common initial sign is spasm of the muscles of the jaw or lockjaw”. Other signs may follow lockjaw.These can include painful spasms in other muscle groups in the neck, trunk, and extremities and generalized, seizure-like activity or convulsions in severe cases. Nervous system abnormalities, as well as a variety of complications related to severe spasm and prolonged hospitalization, can accompany generalized tetanus. The clinical course of generalized tetanus is variable and depends on the
- Degree of prior immunity
- Amount of toxin present
- Age and general health of the patient
- Even with modern intensive care, generalized tetanus is associated with death rates of 10% to 20%.
Localized Tetanus Localized tetanus is an unusual form of the disease consisting of muscle spasms in a confined area close to the site of the injury. Although localized tetanus often occurs in people with partial immunity and is usually mild, progression to generalized tetanus can occur. Cephalic Tetanus The rarest form, cephalic tetanus, is associated with lesions of the head or face and may also be associated with otitis media. The incubation period is short, usually 1 to 2 days. Unlike generalized and localized tetanus, cephalic tetanus results in flaccid cranial nerve palsies rather than spasm. Spasm of the jaw muscles may also be present. Like localized tetanus, cephalic tetanus can progress to the generalized form.
Symptoms
People often call tetanus lockjawbecause one of the most common signs of this infection is tightening of the jaw muscles. Tetanus infection can lead to serious health problems, including being unable to open the mouth and having trouble swallowing and breathing. Symptoms of tetanus include:
- The first sign is most commonly spasms of the muscles of the jaw, or lockjaw.”
- Jaw cramping
- Sudden, involuntary muscle tightening (muscle spasms) — often in the stomach
- Painful muscle stiffness all over the body
- Trouble swallowing
- Jerking or staring (seizures)
- Headache
- Fever and sweating
- Changes in blood pressure and heart rate.
Complications
- Serious health problems that can happen because of tetanus include:
- Uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
- Broken bones (fractures)
- Infections gotten by a patient during a hospital visit (hospital-acquired infections)
- Blockage of the main artery of the lung or one of its branches by a blood clot that has travelled from elsewhere in the body through the bloodstream (pulmonary embolism)
- Pneumonia, a lung infection, that develops by breathing in foreign materials (aspiration pneumonia)
- Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal)
Diagnosis
Doctors can diagnose tetanus by examining the patient and looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus.
Treatment
Tetanus is a medical emergency requiring:
- Care in the hospital
- Immediate treatment with medicine called human tetanus immune globulin (TIG)
- Aggressive wound care
- Drugs to control muscle spasms
- Antibiotics
- Tetanus vaccination
- Depending on how serious the infection is, a machine to help you breathe may be required.
Treatment of tetanus cases with TIG
- Medical experts recommend a single dose of human TIG for treatment of persons with tetanus. Researchers have not established the optimal therapeutic dose. However, experts recommend 500 international units (IU), which appears to be as effective as higher doses ranging from 3,000 to 6,000 IU and causes less discomfort.
- If TIG is not available, clinicians can use IGIV at a dose of 200 to 400 milligrams per kilogram (mg/kg). However, the Food and Drug Administration has not approved IGIV for this use. In addition, anti-tetanus antibody content varies from lot to lot.
Vaccination during Recovery Tetanus disease does not result in tetanus immunity. Clinicians should begin or continue active immunization with a tetanus toxoid-containing vaccine as soon as the person’s condition has stabilized.
Prevention
Vaccination and good wound care are important to help prevent tetanus infection. Vaccination Being up to date with your tetanus vaccine is the best tool to prevent tetanus.Protection from vaccines, as well as a prior infection, do not last a lifetime. This means that if you had tetanus or got the vaccine before, you still need to get the vaccine regularly to keep a high level of protection against this serious disease. Several vaccines protect against tetanus, all of which also protect against other diseases:
- DTaP protects against diphtheria, tetanus, and pertussis (whooping cough)
- DT protects against diphtheria and tetanus
- Tdap protects against tetanus, diphtheria, and pertussis
- Td protects against tetanus and diphtheria
Good Wound Care Immediate and good wound care can also help prevent infection.
- Don’t delay first aid of even minor, non-infected wounds like blisters, scrapes, or any break in the skin.
- Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible.
External links
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* Firmicutes (low-G+C) Infectious diseases
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NIH genetic and rare disease info
Tetanus is a rare disease.
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Rare diseases - Tetanus
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