A 6 year old boy in Oregon was hospitalized with tetanus. It took 57 days and over $800,000 for him to regain his health and go home!
This blog post will discuss who is at risk of this painful disease; what tetanus is; how to prevent it; how someone gets it; and how it is treated.
What is tetanus?
- Tetanus is also known as lockjaw.
- Often, the patient first shows spasms of the jaw muscles.
- The jaw cramps up, or locks in place…
- hence the name lockjaw.
- The jaw cramps up, or locks in place…
- Soon, the patient is unable to even open his mouth and
- has trouble swallowing and breathing.
- Often, the patient first shows spasms of the jaw muscles.
Additional symptoms of tetanus include
- sudden muscle spasms in the stomach
- board-like rigid abdomen
- painful tightening of muscles all over the body
- these spasms may be triggered by
- loud noises, light, or physical contact
- these spasms may be triggered by
- seizures
- involuntary jerking (i.e. you have no control over it)
- headache
- fever
- sweating
- changes in blood pressure and heart rate
Having difficulty breathing can even cause death.
Tetanus is a vaccine-preventable disease.
What causes tetanus?
- Infection from a bacterium called Clostridium tetani causes tetanus.
- These bacteria typically hang out in our environment.
- When the environment gets harsh,
- these bacteria change into tough, hardy forms
- that can resist harshness,
- such as lack of nutrients, dryness etc.
- that can resist harshness,
- These hardy forms are called spores.
- these bacteria change into tough, hardy forms
- When the environment gets harsh,
- These bacteria typically hang out in our environment.
When these spores get inside damaged human tissue,
- the spores change back into their original form
- a form that allows the bacteria to produce the tetanus toxin (poison),
- which causes the damage seen in tetanus.
- a form that allows the bacteria to produce the tetanus toxin (poison),
How do these spores enter the body and cause tetanus?
Spores enter via skin broken by
- nails
- thorns
- wood splinters
- metal splinters
- i.v. drug use
- chronic skin ulcers and wounds
- surgery
- dental infections
- burns
- accidents
- insect bites
- fractures (that exposes the bone)
Other risk factors include
- diabetes, and
- history of immunosuppression
Diagnosis is based on clinical symptoms.
Symptoms overlap with those of strychnine poisoning (caused by ingestion of rat poison).
- Therefore, lab tests have to rule out strychnine poisoning.
How do you treat tetanus?
- Patients are admitted to the ICU.
- immediately treated with human tetanus immune globulin (HTIG)
- shortens the course of tetanus and
- may also reduce severity of illness
- shortens the course of tetanus and
- HTIG is important in
- immediately preventing tetanus toxin (a poison created by Clostridium tetani bacteria)
- from binding irreversibly to tissues.
- immediately preventing tetanus toxin (a poison created by Clostridium tetani bacteria)
- patients are also given metronidazole (brand name Flagyl)
- now considered the antibiotic of choice for tetanus
- immediately treated with human tetanus immune globulin (HTIG)
- supportive therapy aka symptom based treatment, is important in tetanus patients
- controls symptoms
- If patient has a wound that got infected with spores of Clostridium tetani, or
- if patients falls into
- a certain risk category
- Look at section above on ‘How do these spores enter the body and cause tetanus?’
- DEBRIDE (clean) the wound to REMOVE ALL SPORES and DEAD TISSUE
- if tetanus vaccine status on a patient with a certain type of wound (Look at section above on ‘How do these spores enter the body and cause tetanus?’) is UNKNOWN and
- patient hasn’t developed tetanus yet,
- give the tetanus vaccine as a preventive measure
- IF the patient’s records show less than 3 tetanus vaccine doses given,
- give the tetanus vaccine as a preventive measure
- patient hasn’t developed tetanus yet,
- a certain risk category
- if patients falls into