TETANUS---Signs,symptoms & Treatement

Tetanus is infection of the nervous system with the potentially deadly bacteria Clostridium tetani (C. tetani).

Causes, incidence, and risk factors

Spores of the bacteria C. tetani live in the soil and are found around the world. In the spore form, C. tetani may remain inactive in the soil, but it can remain infectious for more than 40 years.
Infection begins when the spores enter the body through an injury or wound. The spores release bacteria that spread and make a poison called tetanospasmin. This poison blocks nerve signals from the spinal cord to the muscles, causing severe muscle spasms. The spasms can be so powerful that they tear the muscles or cause fracture of the spine.
The time between infection and the first sign of symptoms is typically 7 to 21 days. Most cases of tetanus in the United States occur in those who have not been properly vaccinated against the disease.

Symptoms

Tetanus often begins with mild spasms in the jaw muscles (lockjaw). The spasms can also affect the chest, neck, back, and abdominal muscles. Back muscle spasms often cause arching, called ophisthotonus.
Sometimes the spasms affect muscles that help with breathing, which can lead to breathing problems.
Prolonged muscular action causes sudden, powerful, and painful contractions of muscle groups. This is called tetany. These episodes can cause fractures and muscle tears.
Other symptoms include:

• Drooling
  
• Excessive sweating
• Fever
  
• Hand & foot spasms
  
• Irritability
• Swallowing difficulty
• Uncontrolled urination or defecation

Signs and tests

Your doctor will perform a physical exam and ask questions about your medical history. No specific lab test is available to determine the diagnosis of tetanus.
Other tests may be used to rule out meningitis,rabies strychnine poisoning, and other diseases with similar symptoms.

Treatment

Treatment may include:

• Antibiotics, including penicillin, clindamycin erythromycin, or metronidazole (metronidazole has been most successful)
• Bedrest with a nonstimulating environment (dim light, reduced noise, and stable temperature)
• Medicine to reverse the poison (tetanus immune globulin)
• Muscle relaxers such as Diazepam
• Sedatives
• Surgery to clean the wound and remove the source of the poison (debridement)

Breathing support with oxygen, a breathing tube, and a breathing machine may be necessary.