Tetanus
GENERAL PRINCIPLES
• Caused by Clostridium tetani toxin from wound contamination with spores.
• Tetanus is best prevented by immunization. For high-risk wounds, additional prophylaxis with human tetanus immunoglobulin 250 units IM is recommended.3
DIAGNOSIS
Diagnosis is clinical.
Classically presents with intensely painful muscle spasms and rigidity, followed by autonomic dysfunction. Symptoms often begin in the face (trismus, risus sardonicus) and neck muscles. Delirium and high fever are usually absent.TREATMENT
• Passive immunization with human tetanus immunoglobulin 3000-6000 units IM (in divided doses with part infiltrated around the wound) to neutralize unbound toxin is warranted. Active immunization with tetanus toxoid should be given at a separate site.
• Surgical debridement of the wound is critical.
• Antibiotic therapy, usually consisting of metronidazole 500 mg IV q6-8h or penicillin G 2-4 million units IV q4-6h, for 7-10 days is recommended.
• Benzodiazepines or neuromuscular blocking agents may be used to control spasms.
More on the topic Tetanus:
- THE CLOSTRIDIAL DISEASES
- First aid for heart failure
- NERVOUS DISEASES
- PASSIVE IMMUNIZATION
- Disorders With Rigidity
- CLITORAL RELATIVISMFEMALE GENITAL MUTILATION IN “TOLERANT" ISLAMIC INDONESIA
- ESSENTIAL ANTENATAL CARE
- HYPERSENSITIVITY DISORDERS
- Acute Burn Management
- APPENDICES