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==Overview==
==Overview==


The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals,  fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. History of recent accident or an injury leading to break in the continuity of the skin in the a contaminated environment is helpful in making a diagnosis.<ref name="urlTetanus | Symptoms and Complications | Lockjaw | CDC">{{cite web |url=https://www.cdc.gov/tetanus/about/symptoms-complications.html |title=Tetanus &#124; Symptoms and Complications &#124; Lockjaw &#124; CDC |format= |work= |accessdate=}}</ref><ref>{{Cite journal
The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals,  fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. History of recent accident or an injury leading to break in the continuity of the skin in the a contaminated environment is helpful in making a diagnosis.[[Trismus]], or [[lockjaw]], [[spasms]] of the facial muscles ([[risus sardonicus]]), neck [[stiffness]] and swallowing difficulty are some important symptoms of tetanus.<ref name="urlTetanus | Symptoms and Complications | Lockjaw | CDC">{{cite web |url=https://www.cdc.gov/tetanus/about/symptoms-complications.html |title=Tetanus &#124; Symptoms and Complications &#124; Lockjaw &#124; CDC |format= |work= |accessdate=}}</ref><ref>{{Cite journal
  | author = [[Anisha Doshi]], [[Clare Warrell]], [[Dima Dahdaleh]] & [[Dimitri Kullmann]]
  | author = [[Anisha Doshi]], [[Clare Warrell]], [[Dima Dahdaleh]] & [[Dimitri Kullmann]]
  | title = Just a graze? Cephalic tetanus presenting as a stroke mimic
  | title = Just a graze? Cephalic tetanus presenting as a stroke mimic
Line 41: Line 41:


'''Local Tetanus'''  
'''Local Tetanus'''  
*Injury of the particular area followed by spasmodic contraction limited to the injured area.
 
*Contractions of local tetanus may take weeks to subside.
*Localized injury
*Generalized tetanus may be preceded by local tetanus.
*Contaminated wound
*Spasmodic contraction limited to area of injury
*May continue for weeks  
*Can lead to features of generalized tetanus


'''Cephalic Tetanus'''  
'''Cephalic Tetanus'''  
*It is a rare form of the disease, occasionally occurring with [[otitis media]] (ear infections) in which C. tetani is present in the flora of the middle ear, or following injuries to the head.
 
*There is involvement of the [[cranial nerve]]s, especially in the facial area.
*Rare
*Associated with [[otitis media]] (ear infections with [[C. tetani]] present in the middle ear), or after head injuries
*[[Cranial nerve]] involved specially facial area


'''Generalized Tetanus'''  
'''Generalized Tetanus'''  
*Descending spasm of muscles
 
*The first sign is [[trismus]] or lockjaw, followed by  
*Descending muscle spasm
**Stiffness of the neck
*The first sign is [[trismus]] or lockjaw. It can be followed by  
**Difficulty in swallowing
**Neck stiffness
**Rigidity of pectoral and calf muscles.
**Swallowing difficulty
*Other symptoms include  
**Stiffening of the calf and pectoral muscle groups
**Elevated temperature
 
*Some other symptoms of tetanus may include:
**Temperature elevation
**Sweating
**Sweating
**Elevated [[blood pressure]]
**[[Blood pressure]] elevation
**Episodic tachycardia  
**Episodes of tachycardia  
*[[Spasm]]s may occur frequently and last for several minutes. Spasms continue for 3–4 weeks and complete recovery may take months.
*Episodic [[spasm]]s (for minutes), may remain occur for weeks to  months
*History of cephalic or localized tetanus
*History of cephalic or localized tetanus
*History of injury  
*History of injury  


'''Neonatal Tetanus'''  
'''Neonatal Tetanus'''  
Neonatal tetanus may present with a history of:<ref>{{Cite journal
Neonatal tetanus may present with a history and symptoms of:<ref>{{Cite journal
  | author = [[Martha H. Roper]], [[Jos H. Vandelaer]] & [[Francois L. Gasse]]
  | author = [[Martha H. Roper]], [[Jos H. Vandelaer]] & [[Francois L. Gasse]]
  | title = Maternal and neonatal tetanus
  | title = Maternal and neonatal tetanus
Line 77: Line 84:
  | pmid = 17854885
  | pmid = 17854885
}}</ref>
}}</ref>
*Generalized tetanus occurring in newborn infants.
*Generalized tetanus  
*History of use of  non-sterile instrument to cut the umblical stump  
*Newborn infants
*Umblical stump covered with cow dung or juice etc
*Unhygienic umbilical stump clamping
*Umbilical stump covering with cow dung or juice etc






The infection causes painful tightening of the [[muscles]], usually all over the [[body]]. It can lead to "locking" of the [[jaw]], which makes it impossible to open your [[mouth]] or [[swallow]]. If this happens, you could [[die]] of [[suffocation]].
Tetanus can lead to painful tightening of the [[muscles]], usually all over the [[body]]. It can cause stiffening of the jaw muscles referred to as the  "locking" of the [[jaw]], leading to difficulty in opening the [[mouth]] and [[swallowing]].Death by [[suffocation]] may also occur.
 
*[[Trismus]], or [[lockjaw]]
*[[Trismus]], or [[lockjaw]]
*Facial [[spasms]] called [[risus sardonicus]]  
*[[Spasms]] of the facial muscles ([[risus sardonicus]])
*[[Stiffness]] of the [[neck]]
*[[Neck]] [[stiffness]]
*Difficulty in swallowing
*Swallowing problems
*Rigidity of [[pectoral]] and [[calf]] muscles.
*Stiffening of [[calf]] and [[pectoral]] muscle groups
*Elevated [[temperature]]
*[[Sweating]]
*[[Sweating]]
*Elevated [[blood pressure]]
*[[Temperature]] elevation
*Episodic rapid [[heart rate]].
*[[Blood pressure]] elevation
*Spasms may occur frequently and last for several minutes with the body shaped into a characteristic form called [[opisthotonos]]. Spasms continue for up to 4 weeks, and complete recovery may take months.
*Episodes of [[tachycardia]]
*[[Neonatal]] tetanus is a form of generalized tetanus that occurs in newborns.
*Frequent spasms lasting for minutes with characteristic body shape ([[opisthotonos]]). Spasms may take months to recover.
 


==References==
==References==

Revision as of 15:30, 8 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals, fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. History of recent accident or an injury leading to break in the continuity of the skin in the a contaminated environment is helpful in making a diagnosis.Trismus, or lockjaw, spasms of the facial muscles (risus sardonicus), neck stiffness and swallowing difficulty are some important symptoms of tetanus.[1][2]

History and Symptoms

The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals, fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. Contamination of the umbilical cord may also be an important history finding.[3][4]

Local Tetanus

  • Localized injury
  • Contaminated wound
  • Spasmodic contraction limited to area of injury
  • May continue for weeks
  • Can lead to features of generalized tetanus

Cephalic Tetanus

Generalized Tetanus

  • Descending muscle spasm
  • The first sign is trismus or lockjaw. It can be followed by
    • Neck stiffness
    • Swallowing difficulty
    • Stiffening of the calf and pectoral muscle groups
  • Some other symptoms of tetanus may include:
    • Temperature elevation
    • Sweating
    • Blood pressure elevation
    • Episodes of tachycardia
  • Episodic spasms (for minutes), may remain occur for weeks to months
  • History of cephalic or localized tetanus
  • History of injury

Neonatal Tetanus Neonatal tetanus may present with a history and symptoms of:[5]

  • Generalized tetanus
  • Newborn infants
  • Unhygienic umbilical stump clamping
  • Umbilical stump covering with cow dung or juice etc


Tetanus can lead to painful tightening of the muscles, usually all over the body. It can cause stiffening of the jaw muscles referred to as the "locking" of the jaw, leading to difficulty in opening the mouth and swallowing.Death by suffocation may also occur.


References

  1. "Tetanus | Symptoms and Complications | Lockjaw | CDC".
  2. Anisha Doshi, Clare Warrell, Dima Dahdaleh & Dimitri Kullmann (2014). "Just a graze? Cephalic tetanus presenting as a stroke mimic". Practical neurology. 14 (1): 39–41. doi:10.1136/practneurol-2013-000541. PMID 24052566. Unknown parameter |month= ignored (help)
  3. World Health Organization (2000-11-01). "Maternal and Neonatal Tetanus Elimination by 2005" (PDF). Retrieved 2007-01-26.
  4. Lisa Mitchell, William Adams & Francois Aspesberro (2017). "Case 6: Episodic Stiffness in a 30-month-old Girl". Pediatrics in review. 38 (1): 52–53. doi:10.1542/pir.2014-0142. PMID 28044038. Unknown parameter |month= ignored (help)
  5. Martha H. Roper, Jos H. Vandelaer & Francois L. Gasse (2007). "Maternal and neonatal tetanus". Lancet (London, England). 370 (9603): 1947–1959. doi:10.1016/S0140-6736(07)61261-6. PMID 17854885. Unknown parameter |month= ignored (help)

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