Tetanus

 

What is tetanus?

The word 'tetanus' describes a specific set of symptoms that may result after infection with an organism called Clostridium Tetani.  

Clostridium Tetani is gram-positive, (meaning it stains blue when a certain dye is applied to the sample), and anaerobic, (meaning the organism is typically found in environments without oxygen).  

Tetanus results because the Clostridium Tetani organism produces a type of poison called an exotoxin (tetanospasmin) which enters the nervous system and binds to the ganglioside membranes of the nervous tissues.  

Tetanus is most likely to develop as a result of a contaminated wound, particularly in the foot. 

What are the symptoms of tetanus? 

The classic symptom of tetanus is "lockjaw", a condition consisting of stiffness, pain and muscle spasms of the jaw.  Similar symptoms may affect other facial muscles, and the afflicted individual may also have difficulty swallowing.  Fever, headaches, and sore throat often accompany tetanus. 

It is quite possible for the condition to get bad enough for the infected to die, particularly if very young, very old, sick or if the patient is a drug user. 

How can you treat a patient for tetanus? 

Once the toxin binds with the nervous tissue, there's not much you can do.  So treatment consists of prophylaxis--that is, treating all susceptible wounds before the infection develops.

If a patient has a dirty wound, prophylaxis for tetanus usually consists of the following: 

1.  If the patient has never been immunized before, two things are done:  First, a Tetanus Immune Globulin (TIG) intramuscular injection of 250 Units is given.  Second, an intramuscular injection of Diptheria Tetanus Toxoid (dTd) is given in the other arm.

2.  If the patient has been previously immunized, but hasn't had a booster in the past five years, a Diptheria Tetanus Toxoid (dTd) booster is given.

3.  If the patient has had a booster within the previous 5 years, no tetanus prophylaxis is usually administered.   

 

 

 

 

 

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S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
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