Another killer disease- Tetanus

TETANUS (LOCK JAW)
Is an acute infectious disease affecting the neuromuscular system characterized by muscular spasm, stiffness and rigidity.
It is commonly known as “lock jaw” because the muscular spasm which characterized it, frequently attack the muscles of the jaw.
CAUSATIVE ORGANISM: – It is caused by the anaerobic spore-forming rod known as clostridium tetani

MODE OF ACCESS/TRANSMISSION
The organism is usually found in the soil or on rusted tools and infection of wound by contaminated soil and dust.
It usually infect people through penetrated or punctured wounds with contaminated articles like blade and knives
Use of unsterilized dressing or items
Sometimes it may follow injuries or burns through contamination
They are also found in the gut of human beings and domestic animals
Cutting of cord of babies with contaminated instrument
Circumcision with infected instrument.
INCUBATION PERIOD: – Is between 4 – 21 days

PATHOPHYSIOLOGY
Clostridium tetani is an anaerobic organism which is very resistant to the ordinary method of sterilization.
On entering the tissue through a cut or wound they enter the blood stream to the nerve, and produces necrosis and a powerful exotoxin called Tetano Spasmin that destroys the motor nerve ending and break down the red blood cells.
The stimulation of the motor nerve ending affects skeletal muscles causing spasms in the individual.

CLINICAL FEATURES
Sudden onset with headaches
Fever
Malaise
Spasms of the jaw muscle
There is spasm of the facial muscle where the mouth can be opened with difficulty in a situation called TRISMUS
There is RISUS SARDINICUS: this is drawing up of the angle of the mouth giving rise t a characteristic smile.
There is Opisthotonus (muscle spasms causes the back to arched and the head retracted)
There is positive Kernig’s sign
There is photophobia
There is muscular rigidity
Spasm of the sphincter muscles of the body making swallowing , defeacation and micturation very difficult
There is convulsion or fit
Spasm may affect every muscle in the body and in severe cases the muscle rupture
Painful muscular spasms
Insomnia
Spasm of the respiratory muscles causes distress and prolongs period of anoxia
Pyrexia
Tachycardia