Tetanus Symptoms:Signs and shot of tetanus.

Tetanus symptoms

Tetanus is an acute infectious disease caused by clostridium tetani, and characterized by intermittent tonic spasms of the masseters resulting in what is commonly known as lock jaw. Worldwide tetanus causes almost 50,000 deaths annually. Generally the elderly patients and patients with significant burn injuries and surgical wounds are the most susceptible of developing tetanus. Infections may also be seen post partum in the uterus known as maternal tetanus and in new borns near the umbilical region known as tetanus neonatroum. Clinically the disease does not confer immunity. Tetanus is a preventable disease of great significance particularly the neonatal form in developing countries. The symptoms of tetanus are caused by an exotoxin (tetanospasmin) elaborated by clostridium tetani, a gram positive anaerobic spore forming bacillus. Tetanus may follow trivial or even inapparent wounds if the oxygen content of the injured tissue is low. The toxin may enter the CNS along the peripheral motor nerves or maybe blood borne to the nervous tissue. The incubation period ranges from 2 to 50 days.

Signs and symptoms; the most frequent symptom associated with tetanus is jaw stiffness. Other symptoms include difficulty in swallowing, restlessness, irritability, stiff neck arms or legs, headache, fever , sore throat, chills, and tonic spasms. later symptoms include difficulty in opening the mouth, facial muscle spasms produces a characteristic expression with a fixed smile and elevated eyebrows. Rigidity or spasm of abdominal neck or back muscles and even episthotonos may occur. Sphincteral spasm may cause urinary retention or constipation. Dysphagia is another symptom which interferes with nutrition. characteristic painful, generalized tonic spasm with profuse sweating are precipitated by a minor disturbance such as a draft or by noise or by jarring the bed. The patients mental status is usually lucid , but coma may occur after repeated spasms. During a generalized spasm the patient is unable to speak or cry because of chest wall rigidity or glottal spasm. This interfers with normal breathing, the patient might feel cyanotic or even might experience a fatal episode of asphyxia. The immediate cause of death may not always be apparent. The patients temperature id moderately elevated except when a complicating infection, such as pneumonia is present. Respiratory and pulse rates are usually elevated, and reflexes are often exaggerated, moderate leukocytosis may also be seen. Localized tetanus meaning the tetanus has not affected CNS, though rare can occur involving only a few groups of muscle usally muscale near the wound. This spasticity may persist for weeks , cephalic tetanus more common in children , is associated with chronic otitis media, the incidence of this is greatest in Africa. All the cranial nerves are usaully involved,however the commonest amongst them is the facial nerve or the 7 cranial nerve. Cephalic tetanus may eventually become generalized. Bilateral perceptual deafness has been reported in newborns.

The diagnosis of tetanus is based on a wound in patients presenting with muscular stiffness or spasms this acts as a clue. Tetanus can sometimes be confused with meningoencephalitis of bacterial or viral origins. Clostridium tetani can be cultured from the wound, but its absence does not negate the diagnosis.