Region Type of virus Transmission Route Incubation Period Source of Infection Sign Symptom Complication Virulence Factor Dif. Diagnosis Epidemiology Prophylaxis
Bacterial infections Clostridium tetnus Through punctured wounds, surgical operations due to lack of asepsis, application of cowdung on the umbilical stump. 6-12 days Na Muscle rigidity, spasms ,opistotonus, risus sardoricus,trismus, difficulty in swallowing Fever,sweating,hypertension, rapid rate rate Airway Aspiration* Laryngospasm/obstruction* Sedative associated obstruction* Respiratory Apnoea* Hypoxia* Type I* (atelectasis, aspiration, pneumonia) and type II* respiratory failure (laryngeal spasm, prolonged truncal spasm, excessive sedation) ARDS* Complications of prolonged assisted ventilation (e.g. pneumonia) Tracheostomy complications (e.g. tracheal stenosis) Cardiovascular Tachycardia*, hypertension*, ischaemia* Hypotension*, bradycardia* Tachyarrhythmias, bradyarrhythmias* Asystole* Cardiac failure* Renal High output renal failure* Oliguric renal failure* Urinary stasis and infection Gastro‐intestinal Gastric stasis Ileus Diarrhoea Haemorrhage* Miscellaneous Weight loss* Thromboembolus* Sepsis and multiple organ failure* Fractures of vertebrae during spasms Tendon avulsions during spasms Tatanospasmin toxin Oro-facial infection,dystonicdrug reaction,hypocalcaemia, strychinine poisoning,hysteria South east Asia Tetnus toxoid and immunoglobulin
Bacterial infections Clostridium tetani Wound contamination with soil ( eg. road traffic accident ) 2 days to several weeks ( 6 to 12 days avg) Na Increase in masseter tone leading to trismus or lock jow followed by muscle pain & stiffness back pain and difficulty in swallowing followed by painful muscle spasms in affected limb & leading to generalised spasms followed by descending spastic paralysis Increase in masseter tone leading to trismus or lock jow followed by muscle pain & stiffness back pain and difficulty in swallowing followed by painful muscle spasms in affected limb & leading to generalised spasms followed by descending spastic paralysis 2- exotoxins , 1- Tetanolysin ( hemmunolysin) 2 - Tetanospasmin ( neurotoxin ) Active immunization - 1 - Tetnus toxoid ( deep 1 m ) children : Anterolatral aspect high , Adult : Dectoid . in combined vaccine with( DPT) or monovalent vaccine (TT) 2 - Surgically removal of foreign bodies , nerotic tissue , blood clot to present anaerobic enviroment 3- Antibiotic ( no role on toxin ) Penicillin injection ( Doc) or Enythromycin 500 mg bd . 5 days and neomycin / Bacitracin apply locally