ad
This Article
Right arrow Images Only
Right arrow Full Version
Services
Right arrow E-mail this link to a friend
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Section 1
Section 2
Section 3
Section 4
Section 5
Appendices
Right arrow Earn CME - What's This?
Related Collections
Right arrowRelated Articles

The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Tetanus

(Lockjaw)

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

Top
 Next
See Images

CLINICAL MANIFESTATIONS

Generalized tetanus (lockjaw) is a neurologic disease manifesting as trismus and severe muscular spasms. Tetanus is caused by neurotoxin produced by the anaerobic bacterium Clostridium tetani in a contaminated wound. Onset is gradual, occurring over 1 to 7 days, and symptoms progress to severe generalized muscle spasms, which often are aggravated by any external stimulus. Severe spasms persist for 1 week or more and subside over several weeks in people who recover.

Neonatal tetanus is a form of generalized tetanus occurring in newborn infants lacking protective passive immunity because their mothers are not immune. Localized tetanus manifests as local muscle spasms in areas contiguous to a wound. Cephalic tetanus is a dysfunction of cranial nerves associated with infected wounds on the head and neck. Both of the latter conditions may precede generalized tetanus.


Top
 Previous
Next
See Images

ETIOLOGY

C tetani is a spore-forming, anaerobic, gram-positive bacillus. This organism is a wound contaminant that causes neither tissue destruction nor an inflammatory response. The vegetative form of C tetani produces a potent plasmid-encoded exotoxin (tetanospasmin), which binds to gangliosides at the myoneural junction of skeletal muscle and on neuronal membranes in the spinal cord, blocking inhibitory impulses to motor neurons. The action of tetanus toxin on the brain and sympathetic nervous system is less well documented.


Top
 Previous
Next
See Images

EPIDEMIOLOGY

Tetanus occurs worldwide and is more common in warmer climates and during warmer months, in part because of the higher frequency of contaminated wounds associated with those locations and seasons. The organism, a normal inhabitant of soil and animal and human intestines, is ubiquitous in the environment, especially where contamination by excreta is common. Organisms multiply in wounds, recognized or unrecognized, and elaborate toxins in . . . [Go to Full Text]


Related Articles

Reporting of Adverse Events
Red Book 2009 2009: 42-51. [Extract] [Full Text]

Scheduling Immunizations
Red Book 2009 2009: 21-31. [Extract] [Full Text]

Simultaneous Administration of Multiple Vaccines
Red Book 2009 2009: 33-34. [Extract] [Full Text]

Antibodies of Animal Origin (Animal Antisera)
Red Book 2009 2009: 61a-65a. [Extract] [Full Text]

Active Immunization After Exposure to Disease
Red Book 2009 2009: 87-88. [Extract] [Full Text]

Immunizations
Red Book 2009 2009: 183-184. [Extract] [Full Text]

Injuries From Discarded Needles in the Community
Red Book 2009 2009: 184-187. [Extract] [Full Text]

Bite Wounds
Red Book 2009 2009: 187-191. [Extract] [Full Text]

Diphtheria
Red Book 2009 2009: 280-283. [Extract] [Full Text]

Human Immunodeficiency Virus Infection
Red Book 2009 2009: 380a-400a. [Extract] [Full Text]

Pertussis (Whooping Cough)
Red Book 2009 2009: 504-519. [Extract] [Full Text]