tetanus2 198x300 Signs of tetanusTetanus is an acute infection with clinical symptoms of acute neuromuscular disorder, the form of stiffness and muscle spasms

Etiology: Clostridim tetani
anaerobic nature have spores, spores found in soil and dust and can survive many years, resistance to antiseptics and temperature of 100 Celsius

Typical shapes such as squash racquets

Pathogenesis

Clostridium enter through wounds (lacerations, gunshot wounds, stab wounds, burns, bites, pets, etc.)

60% of tetanus occur due to stab wound in the leg.

It can also be through the uterus in abortion provokatus

can also be through the umbilicus in infants who helped with ignoring the rules asepsis.

Toxin:

  1. Tetanolisin destroy erythrocytes
  2. Tetanospasmin (proteins that are toxic against nerve cells) absorbed motor nerve endings CNS ganglion nerve fibers.

Clinical Manifestation

  • Incubation period: 3 days to 4 weeks (average 8 days)
  • shorter incubation period, the higher the mortality.

Symptoms:

  1. Local tetanus stiff muscles wound area
  2. General tetanus
  • Trismus (stiff muscles maseter hard to open mouth)
  • Opistotonus (stiff neck, neck and back)
  • Abdominal wall as a board
  • Risus sardonikus (stiff facial muscles)
  • It is hard to swallow
  • Stiffness of the respiratory muscles

DIAGNOSIS

From the clinical symptoms, because examination of Clostridium bacteria often can not be found, sufficient to MDX tetanus.

DIAGNOSIS OF APPEAL

Trismus due to local problem in mouth

Meningitis encephalitis

TREATMENT
  1. Principle of treatment:
  • Exotoxin that has been overcome due to
  • cells bound the central nervous with symptomatic anti-seizure (phenobarbital,CPZ, diasepam)

Trakheostomi respiratory failure, installation of ventilator

Neutralize the toxin still circulating for the blood

ATS 20,000 IU / day 5 days SLM

Human immunoglobulin dose of 3000-6000 IU

Eliminate germs cause with antiseptic wound care, wound excision Penicillin

PREVENTION

  1. Adequate wound care
  2. active immunization with human immunoglobulin tetanus

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