AskDefine | Define tetanus

Dictionary Definition

tetanus

Noun

1 an acute and serious infection of the central nervous system caused by bacterial infection of open wounds; spasms of the jaw and laryngeal muscles may occur during the late stages [syn: lockjaw]
2 a sustained muscular contraction resulting from a rapid series of nerve impulses

User Contributed Dictionary

English

Noun

  1. A serious and often fatal disease arising through infection of an open wound by the anaerobic bacterium Clostridium tetani that is found in soil and the intestines and faeces of animals. The bacteria produce an exotoxin which causes spasmodic contraction of voluntary muscles, especially those of the neck and jaw.
  1. A state of muscle tension caused by sustained contraction arising from a rapid series of nerve impulses which do not allow the muscle to relax.

Synonyms

Derived terms

Translations

disease

Czech

Noun

  1. tetanus

Extensive Definition

Tetanus is a medical condition that is characterized by a prolonged contraction of skeletal muscle fibres. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. Infection generally occurs through wound contamination, and often involves a cut or deep puncture wound. As the infection progresses, muscle spasms in the jaw develop, hence the common name, lockjaw. This is followed by difficulty in swallowing and general muscle stiffness and spasms in other parts of the body. Infection can be prevented by proper immunization and by post-exposure prophylaxis.

Signs and symptoms

Tetanus affects skeletal muscle, a type of striated muscle. The other type of striated muscle, cardiac or heart muscle cannot be tetanized, because of its intrinsic electrical properties. In recent years, approximately 11% of reported tetanus cases have been fatal. The highest mortality rates are in unvaccinated persons and persons over 60 years of age. C. tetani, the bacterium that causes tetanus, is recovered from the initial wound in only about 30% of cases, and can be found in patients who do not have tetanus.

Spatula test

The "spatula test" for tetanus involves touching the posterior pharyngeal wall with a sterile, soft-tipped instrument, and observing the effect. A positive test result is the involuntary contraction of the jaw (biting down on the "spatula"), and a negative test result would normally be a gag reflex attempting to expel the foreign object.
A short report in The American Journal of Tropical Medicine and Hygiene states that in a patient research study, the spatula test had a high specificity (zero false-positive test results) and a high sensitivity (94% of infected patients produced a positive test result).

Treatment

The wound must be cleaned. Dead and infected tissue should be removed by surgical debridement. Metronidazole treatment decreases the number of bacteria but has no effect on the bacterial toxin. Penicillin was once used to treat tetanus, but is no longer the treatment of choice, owing to a theoretical risk of increased spasms. However, its use is recommended if metronidazole is not available. Passive immunization with human anti-tetanospasmin immunoglobulin or tetanus immune globulin is crucial. If specific anti-tetanospasmin immunoglobulin is not available, then normal human immunoglobulin may be given instead. All tetanus victims should be vaccinated against the disease or offered a booster shot. It takes 2-14 days for symptoms to develop after infection. Symptoms peak 17 days after infection.

Mild tetanus

Mild cases of tetanus can be treated with:

Severe tetanus

Severe cases will require admission to intensive care. In addition to the measures listed above for mild tetanus:
Drugs such as chlorpromazine or diazepam, or other muscle relaxants can be given to control the muscle spasms. In extreme cases it may be necessary to paralyze the patient with curare-like drugs and use a mechanical ventilator.
In order to survive a tetanus infection, the maintenance of an airway and proper nutrition are required. An intake of 3500-4000 Calories, and at least 150g of protein per day, is often given in liquid form through a tube directly into the stomach, or through a drip into a vein. This high-caloric diet maintenance is required because of the increased metabolic strain brought on by the increased muscle activity.

Prevention

Tetanus can be prevented by vaccination. The CDC recommends that adults receive a booster vaccine every ten years, and standard care practice in many places is to give the booster to any patient with a puncture wound who is uncertain of when he or she was last vaccinated, or if he or she has had fewer than 3 lifetime doses of the vaccine. The booster cannot prevent a potentially fatal case of tetanus from the current wound, however, as it can take up to two weeks for tetanus antibodies to form. In children under the age of seven, the tetanus vaccine is often administered as a combined vaccine, DPT/DTaP vaccine, which also includes vaccines against diphtheria and pertussis. For adults and children over seven, the Td vaccine (tetanus and diphtheria) or Tdap (tetanus, diphtheria, and acellular pertussis) is commonly used. Nearly all of the cases in the United States occur in unimmunized individuals or individuals who have allowed their inoculations to lapse, whereas most cases in developing countries are due to the neonatal form of tetanus.
Tetanus is the only vaccine-preventable disease that is infectious but is not contagious.

Association with rust

Tetanus is often associated with rust, especially rusty nails, but this concept is somewhat misleading. Objects that accumulate rust are often found outdoors, or in places that harbour anaerobic bacteria, but the rust itself does not cause tetanus nor does it contain more C. tetani bacteria. The rough surface of rusty metal merely provides a prime habitat for a C. tetani endospore to reside. An endospore is a non-metabolising survival structure that begins to metabolise and cause infection once in an adequate environment. Because C. tetani is an anaerobic bacterium, it and its endospores will thrive in an environment that lacks oxygen. Hence, stepping on a nail (rusty or not) may result in a tetanus infection, as the low-oxygen (anaerobic) environment of a puncture wound provides the bacteria with an ideal breeding ground.

Famous tetanus victims

References

External links

tetanus in Bosnian: Tetanus
tetanus in Catalan: Tètanus
tetanus in Czech: Tetanus
tetanus in Welsh: Tetanws
tetanus in Danish: Stivkrampe
tetanus in German: Tetanus
tetanus in Estonian: Teetanus
tetanus in Spanish: Tétanos
tetanus in Esperanto: Tetanoso
tetanus in Basque: Tetanos
tetanus in French: Tétanos
tetanus in Croatian: Tetanus
tetanus in Indonesian: Tetanus
tetanus in Italian: Tetano
tetanus in Hebrew: טטנוס
tetanus in Kurdish: Derdê kopan
tetanus in Latin: Tetanus
tetanus in Lithuanian: Stabligė
tetanus in Malay (macrolanguage): Kancing gigi
tetanus in Dutch: Tetanus
tetanus in Japanese: 破傷風
tetanus in Norwegian: Stivkrampe
tetanus in Polish: Tężec
tetanus in Portuguese: Tétano
tetanus in Russian: Столбняк
tetanus in Albanian: Tetanosi
tetanus in Serbian: Тетанус
tetanus in Finnish: Jäykkäkouristus
tetanus in Swedish: Stelkramp
tetanus in Vietnamese: Bệnh phong đòn gánh
tetanus in Turkish: Tetanos
tetanus in Chinese: 破傷風

Synonyms, Antonyms and Related Words

African lethargy, Asiatic cholera, Chagres fever, German measles, Haverhill fever, Jacksonian epilepsy, Rolandic epilepsy, abdominal epilepsy, access, acquired epilepsy, activated epilepsy, acute articular rheumatism, affect epilepsy, ague, akinetic epilepsy, alkali disease, amebiasis, amebic dysentery, anthrax, apoplexy, arrest, attack, autonomic epilepsy, bacillary dysentery, bastard measles, black death, black fever, blackwater fever, blockage, breakbone fever, brucellosis, bubonic plague, cachectic fever, cardiac epilepsy, cerebral rheumatism, chicken pox, cholera, clonic spasm, clonus, convulsion, cortical epilepsy, cowpox, cramp, cursive epilepsy, dandy fever, deer fly fever, dengue, dengue fever, diphtheria, diurnal epilepsy, dumdum fever, dysentery, eclampsia, elephantiasis, encephalitis lethargica, enteric fever, epilepsia, epilepsia gravior, epilepsia major, epilepsia minor, epilepsia mitior, epilepsia nutans, epilepsia tarda, epilepsy, erysipelas, falling sickness, famine fever, fit, five-day fever, flu, focal epilepsy, frambesia, frenzy, glandular fever, grand mal, grippe, hansenosis, haute mal, hepatitis, herpes, herpes simplex, herpes zoster, histoplasmosis, hookworm, hydrophobia, hysterical epilepsy, ictus, infantile paralysis, infectious mononucleosis, inflammatory rheumatism, influenza, jail fever, jungle rot, kala azar, kissing disease, larval epilepsy, laryngeal epilepsy, laryngospasm, latent epilepsy, lepra, leprosy, leptospirosis, loa loa, loaiasis, lockjaw, madness, malaria, malarial fever, marsh fever, matutinal epilepsy, measles, meningitis, menstrual epilepsy, milzbrand, mumps, musicogenic epilepsy, myoclonous epilepsy, nocturnal epilepsy, occlusion, ornithosis, osteomyelitis, paratyphoid fever, parotitis, paroxysm, parrot fever, pertussis, petit mal, physiologic epilepsy, pneumonia, polio, poliomyelitis, polyarthritis rheumatism, ponos, psittacosis, psychic epilepsy, psychomotor epilepsy, rabbit fever, rabies, rat-bite fever, reflex epilepsy, relapsing fever, rheumatic fever, rickettsialpox, ringworm, rotatoria, rubella, rubeola, scarlatina, scarlet fever, schistosomiasis, seizure, sensory epilepsy, septic sore throat, serial epilepsy, shingles, sleeping sickness, sleepy sickness, smallpox, snail fever, spasm, splenic fever, spotted fever, stoppage, strep throat, stroke, swamp fever, tardy epilepsy, tetany, throes, thromboembolism, thrombosis, thrush, tinea, tonic epilepsy, tonic spasm, torsion spasm, traumatic epilepsy, trench fever, trench mouth, trismus, tuberculosis, tularemia, typhoid, typhoid fever, typhus, typhus fever, ucinate epilepsy, undulant fever, vaccinia, varicella, variola, venereal disease, viral dysentery, visitation, whooping cough, yaws, yellow fever, yellow jack, zona, zoster
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