Tetanus natural history: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(28 intermediate revisions by 5 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Tetanus}}
{{Tetanus}}
{{CMG}}
{{CMG}}; {{AE}}{{USAMA}}


Please help WikiDoc by adding more content here.  It's easy! Click [[Help:How to Edit a Page|here]]  to learn about editing.
==Overview==
Tetanus can have an incubation period of 2 to 38 days. The presentation and progression may vary depending on the type of tetanus. Generalized tetanus can involve the diaphragm making it difficult to breathe. The complications of tetanus include respiratory arrest, [[fracture]]s, [[laryngospasm]], aspiration [[pneumonia]] and [[pulmonary embolism]]. Tetanus has a case fatality rate of approximately 11%. The fatality rate of tetanus is associated with prolonged [[convulsions]] and [[contractions]]. Tetanus without [[spasm]]s has an excellent prognosis. Early diagnosis is associated with a good prognosis.<ref name="pmid25149223">{{cite journal| author=Thwaites CL, Beeching NJ, Newton CR| title=Maternal and neonatal tetanus. | journal=Lancet | year= 2015 | volume= 385 | issue= 9965 | pages= 362-70 | pmid=25149223 | doi=10.1016/S0140-6736(14)60236-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25149223 }} </ref><ref>{{Cite journal
  | author = [[J. C. Patel]] & [[B. C. Mehta]]
| title = Tetanus: study of 8,697 cases
| journal = [[Indian journal of medical sciences]]
| volume = 53
| issue = 9
| pages = 393–401
| year = 1999
  | month = September
| pmid = 10710833
}}</ref>
 
==Natural History==
Tetanus can have an incubation period of 2 to 38 days. Initial presentation involves neck and jaw stiffness. Spasms are common in the first week and may persist for up to 3 weeks, followed by rigidity that can persist for 4-8 weeks. Patients with the generalized type can have spasmodic contractions of the muscles associated with inability to breathe which may lead to [[apnea]]. If left untreated this can lead to the death.<ref name="pmid25149223">{{cite journal| author=Thwaites CL, Beeching NJ, Newton CR| title=Maternal and neonatal tetanus. | journal=Lancet | year= 2015 | volume= 385 | issue= 9965 | pages= 362-70 | pmid=25149223 | doi=10.1016/S0140-6736(14)60236-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25149223  }} </ref><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>


==Complications==
==Complications==
There are many complications associated with tetanus infection. Some of the complications are as follows:
Complications of a tetanus infection may include:
 
*Respiratory or diaphragmatic paralysis
*[[Laryngospasm]]
*[[Laryngospasm]]
**This can be associated with [[spasms]] of the [[muscles]] of [[respiration]] which leads to breathing difficulties.
**This can be associated with [[spasms]] of the [[muscles]] of [[respiration]] which leads to breathing difficulties.
Line 16: Line 30:
*[[Nosocomial]] infections
*[[Nosocomial]] infections
**Common because of prolonged hospitalization
**Common because of prolonged hospitalization
*There are commonly some secondary infections including:
 
**[[Sepsis]] from indwelling catheters
**[[Hospital-acquired pneumonia]]
**[[Decubitus ulcers]]
*[[Pulmonary embolism]]
*[[Pulmonary embolism]]
**Apparent in drug users and the elderly
**Apparent in drug users and the elderly
Line 25: Line 36:
**Common late complication
**Common late complication
**Found in 50%-70% of autopsied cases
**Found in 50%-70% of autopsied cases
Common secondary complications of prolonged hospitalization for tetanus include:
*[[Sepsis]] from indwelling catheters
*[[Hospital-acquired pneumonia]]
*[[Decubitus ulcers]]


==Prognosis==
==Prognosis==
Death in about 10-20% of cases, higher among older people.
Tetanus results in death in approximately 10-20% of cases. The mortality rate is higher among older people. The fatality rate of tetanus is associated with prolonged [[contractions]] and [[convulsions]]. Tetanus without [[spasm]]s has an excellent prognosis. Early diagnosis is associated with a good prognosis.<ref name="pmid25149223">{{cite journal| author=Thwaites CL, Beeching NJ, Newton CR| title=Maternal and neonatal tetanus. | journal=Lancet | year= 2015 | volume= 385 | issue= 9965 | pages= 362-70 | pmid=25149223 | doi=10.1016/S0140-6736(14)60236-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25149223  }} </ref><ref>{{Cite journal
| author = [[C. Louise Thwaites]], [[Nicholas J. Beeching]] & [[Charles R. Newton]]
| title = Maternal and neonatal tetanus
| journal = [[Lancet (London, England)]]
| volume = 385
| issue = 9965
| pages = 362–370
| year = 2015
| month = January
| doi = 10.1016/S0140-6736(14)60236-1
| pmid = 25149223
}}</ref><ref>{{Cite journal
| author = [[Martha H. Roper]], [[Jos H. Vandelaer]] & [[Francois L. Gasse]]
| title = Maternal and neonatal tetanus
| journal = [[Lancet (London, England)]]
| volume = 370
| issue = 9603
| pages = 1947–1959
| year = 2007
| month = December
| doi = 10.1016/S0140-6736(07)61261-6
| pmid = 17854885
}}</ref><ref>{{Cite journal
| author = [[M. H. Trujillo]], [[A. Castillo]], [[J. Espana]], [[A. Manzo]] & [[R. Zerpa]]
| title = Impact of intensive care management on the prognosis of tetanus. Analysis of 641 cases
| journal = [[Chest]]
| volume = 92
| issue = 1
| pages = 63–65
| year = 1987
| month = July
| pmid = 3595250
}}</ref><ref>{{Cite journal
| author = [[J. C. Patel]] & [[B. C. Mehta]]
| title = Tetanus: study of 8,697 cases
| journal = [[Indian journal of medical sciences]]
| volume = 53
| issue = 9
| pages = 393–401
| year = 1999
| month = September
| pmid = 10710833
}}</ref>


In recent years:
*Poor prognostic factors include:
 
**Individuals of age 60 years or older (approximately 18%)
*Tetanus has been fatal in approximately 11% of reported cases
*Most commonly fatal cases found in:
**People of 60 years or older (approximately 18%)
**Unvaccinated people (approximately 22%)
**Unvaccinated people (approximately 22%)
*In about 20% of deaths, no obvious pathology is detected
**Delayed diagnosis
**Death is attributed directly to the direct effects of tetanus toxin.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Disease]]
[[Category:Disease]]
Line 45: Line 101:
[[Category:Needs overview]]
[[Category:Needs overview]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Primary care]]
[[Category:Neurology]]
 
{{WH}}
{{WS}}

Latest revision as of 00:24, 30 July 2020

Tetanus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tetanus from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Xray

CT scan

MRI

Ultrasound

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tetanus natural history On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tetanus natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Tetanus natural history

CDC on Tetanus natural history

Tetanus natural history in the news

Blogs on Tetanus natural history

Directions to Hospitals Treating Tetanus

Risk calculators and risk factors for Tetanus natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Tetanus can have an incubation period of 2 to 38 days. The presentation and progression may vary depending on the type of tetanus. Generalized tetanus can involve the diaphragm making it difficult to breathe. The complications of tetanus include respiratory arrest, fractures, laryngospasm, aspiration pneumonia and pulmonary embolism. Tetanus has a case fatality rate of approximately 11%. The fatality rate of tetanus is associated with prolonged convulsions and contractions. Tetanus without spasms has an excellent prognosis. Early diagnosis is associated with a good prognosis.[1][2]

Natural History

Tetanus can have an incubation period of 2 to 38 days. Initial presentation involves neck and jaw stiffness. Spasms are common in the first week and may persist for up to 3 weeks, followed by rigidity that can persist for 4-8 weeks. Patients with the generalized type can have spasmodic contractions of the muscles associated with inability to breathe which may lead to apnea. If left untreated this can lead to the death.[1][3]

Complications

Complications of a tetanus infection may include:

Common secondary complications of prolonged hospitalization for tetanus include:

Prognosis

Tetanus results in death in approximately 10-20% of cases. The mortality rate is higher among older people. The fatality rate of tetanus is associated with prolonged contractions and convulsions. Tetanus without spasms has an excellent prognosis. Early diagnosis is associated with a good prognosis.[1][4][5][6][7]

  • Poor prognostic factors include:
    • Individuals of age 60 years or older (approximately 18%)
    • Unvaccinated people (approximately 22%)
    • Delayed diagnosis

References

  1. ↑ 1.0 1.1 1.2 Thwaites CL, Beeching NJ, Newton CR (2015). "Maternal and neonatal tetanus". Lancet. 385 (9965): 362–70. doi:10.1016/S0140-6736(14)60236-1. PMID 25149223.
  2. ↑ J. C. Patel & B. C. Mehta (1999). "Tetanus: study of 8,697 cases". Indian journal of medical sciences. 53 (9): 393–401. PMID 10710833. Unknown parameter |month= ignored (help)
  3. ↑ "Tetanus | Symptoms and Complications | Lockjaw | CDC".
  4. ↑ C. Louise Thwaites, Nicholas J. Beeching & Charles R. Newton (2015). "Maternal and neonatal tetanus". Lancet (London, England). 385 (9965): 362–370. doi:10.1016/S0140-6736(14)60236-1. PMID 25149223. 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)
  6. ↑ M. H. Trujillo, A. Castillo, J. Espana, A. Manzo & R. Zerpa (1987). "Impact of intensive care management on the prognosis of tetanus. Analysis of 641 cases". Chest. 92 (1): 63–65. PMID 3595250. Unknown parameter |month= ignored (help)
  7. ↑ J. C. Patel & B. C. Mehta (1999). "Tetanus: study of 8,697 cases". Indian journal of medical sciences. 53 (9): 393–401. PMID 10710833. Unknown parameter |month= ignored (help)

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Tetanus_natural_history&oldid=1643869"