Tetanus: symptoms, treatment, signs, photo
What it is? Tetanus is an acute anaerobic infectious disease that is caused by bacteria and has a contact transfer mechanism.
Very severe pathology, often leading to death as a result of damage to the nervous system.
Mortality is high, the number of tetanus deaths ranks third after rabies and plague. It manifests itself as generalized attacks and tonic contractions of muscles. The onset of the disease is associated with injuries.
How can you get tetanus and what is it? The causative agent of tetanus in humans is the conditionally pathogenic Gram-positive bacterium Clostridium tetani. It is typical for it to develop under anaerobic conditions( without oxygen), and also to form spores that can persist in the soil for a whole century. Due to the special arrangement of the spores, the bacterium looks like a "drumstick".
Normally, a microorganism is present in the intestine of all warm-blooded animals. There lives and multiplies, not bringing harm, and leaves the body in a natural way. Well preserved in the soil rich in humus, from there with dust can fly on any objects.
The tetanus stick has a contact transfer mechanism. This means that the entrance gates for it have various damages to the skin: burns, punctures, cuts, wounds, scrapes.
The bacterium is dangerous because when it enters the body through damaged tissue it produces a very strong substance - tetanus exotoxin. The poison with the blood flow enters the central nervous system. By force this toxin is second only to botulinum toxin, but it is completely safe to swallow, as it is not absorbed in the intestine.
Since the moment when the rod enters the human body and up to clinical manifestations of the disease, it takes about 6-14 days. During this period, the pathogen multiplies and produces poison. The first signs and precursors of tetanus in humans can be: headache, chills, painful sensations when swallowing, loss of appetite. But more often the disease develops sharply against the background of normal state of health.
When the characteristic symptoms of tetanus appear in a person, the wound usually heals, but in its area, the dull pain is beginning to worry. At the same time, trismus occurs-a spasm of chewing musculature that restricts movement in the jaw joint to such an extent that it is impossible to open the mouth. The muscles responsible for chewing shrink convulsively.
Later, two more symptoms of tetanus are added to the trismus: "sardonic smile" and opisthotonus. The first of them is due to the involvement of mimic muscles in the process. The face is distorted by a persistent grimace, in which the corners of the mouth are lowered, and the eyebrows are raised. This painful expression resembles a grin and arises from the prolonged involuntary contraction of the facial muscles.
The opisthotonus is a characteristic posture that is the result of a tonic spasm of the muscles of the back, neck and limbs. The body arches sharply with an arch with support on the heels and the back of the head, the head is thrown back, hands are pressed to the chest, the hands and feet are also bent. This situation can be held for a long period and indicates that the brain stem is affected.
Since tonic tension is transmitted to the intercostal space and the muscles of the diaphragm, hypoxia occurs in response to a decrease in the minute volume of respiration. In the process involved only large muscles, the feature of the lesion is a constant hypertonia and pain. With the course of the disease, under the influence of various stimuli( auditory, auditory, visual), tetanic convulsions develop, sometimes lasting continuously.
Convulsive condition is accompanied by a number of secondary symptoms: hyperthermia, when the temperature rises to 40 °, hypersalivation( salivation), tachycardia, sweating. The person is always conscious and has a strong fear. There are no abnormalities in internal organs.
Death can come from strangulation due to compression of the muscles of the larynx at the peak of convulsive seizures. Most often this happens from stopping breathing or stopping the heart function. Although the death rate is very high, recovery is possible, but it is very slow( up to 2 months).Cramps and muscle tension decrease gradually. This period of time is fraught with various complications, such as pneumonia, heart attack, sepsis, fractures of vertebral bodies, muscle contractures.
Also read the symptoms and treatment of diphtheria.
A scrupulous collection of anamnesis is an early diagnosis of tetanus. In the case of this pathology, laboratory data are of secondary importance, because exotoxin in the blood can not be detected and there are no abnormalities.
Only for tetanus is the combination of trism, "sardonic smile", dysphagia( classical triad), as well as aching pains around healed wounds, and stiff neck muscles.
Therefore, the diagnosis is based on clinical indicators. Characteristic is also the absence of abnormalities from the internal organs.
Treatment takes place in the intensive care unit under the supervision of an anesthesiologist. Complex treatment and treatment of tetanus in humans implies:
Preventive measures are carried out in several directions. There is a nonspecific, specific and emergency prophylaxis of tetanus.
Very severe pathology, often leading to death as a result of damage to the nervous system.
Mortality is high, the number of tetanus deaths ranks third after rabies and plague. It manifests itself as generalized attacks and tonic contractions of muscles. The onset of the disease is associated with injuries.
The causative agent of tetanus in humans
How can you get tetanus and what is it? The causative agent of tetanus in humans is the conditionally pathogenic Gram-positive bacterium Clostridium tetani. It is typical for it to develop under anaerobic conditions( without oxygen), and also to form spores that can persist in the soil for a whole century. Due to the special arrangement of the spores, the bacterium looks like a "drumstick".
Normally, a microorganism is present in the intestine of all warm-blooded animals. There lives and multiplies, not bringing harm, and leaves the body in a natural way. Well preserved in the soil rich in humus, from there with dust can fly on any objects.
The tetanus stick has a contact transfer mechanism. This means that the entrance gates for it have various damages to the skin: burns, punctures, cuts, wounds, scrapes.
The bacterium is dangerous because when it enters the body through damaged tissue it produces a very strong substance - tetanus exotoxin. The poison with the blood flow enters the central nervous system. By force this toxin is second only to botulinum toxin, but it is completely safe to swallow, as it is not absorbed in the intestine.
Symptoms of tetanus
Since the moment when the rod enters the human body and up to clinical manifestations of the disease, it takes about 6-14 days. During this period, the pathogen multiplies and produces poison. The first signs and precursors of tetanus in humans can be: headache, chills, painful sensations when swallowing, loss of appetite. But more often the disease develops sharply against the background of normal state of health.
When the characteristic symptoms of tetanus appear in a person, the wound usually heals, but in its area, the dull pain is beginning to worry. At the same time, trismus occurs-a spasm of chewing musculature that restricts movement in the jaw joint to such an extent that it is impossible to open the mouth. The muscles responsible for chewing shrink convulsively.
Later, two more symptoms of tetanus are added to the trismus: "sardonic smile" and opisthotonus. The first of them is due to the involvement of mimic muscles in the process. The face is distorted by a persistent grimace, in which the corners of the mouth are lowered, and the eyebrows are raised. This painful expression resembles a grin and arises from the prolonged involuntary contraction of the facial muscles.
The opisthotonus is a characteristic posture that is the result of a tonic spasm of the muscles of the back, neck and limbs. The body arches sharply with an arch with support on the heels and the back of the head, the head is thrown back, hands are pressed to the chest, the hands and feet are also bent. This situation can be held for a long period and indicates that the brain stem is affected.
Since tonic tension is transmitted to the intercostal space and the muscles of the diaphragm, hypoxia occurs in response to a decrease in the minute volume of respiration. In the process involved only large muscles, the feature of the lesion is a constant hypertonia and pain. With the course of the disease, under the influence of various stimuli( auditory, auditory, visual), tetanic convulsions develop, sometimes lasting continuously.
Convulsive condition is accompanied by a number of secondary symptoms: hyperthermia, when the temperature rises to 40 °, hypersalivation( salivation), tachycardia, sweating. The person is always conscious and has a strong fear. There are no abnormalities in internal organs.
Death can come from strangulation due to compression of the muscles of the larynx at the peak of convulsive seizures. Most often this happens from stopping breathing or stopping the heart function. Although the death rate is very high, recovery is possible, but it is very slow( up to 2 months).Cramps and muscle tension decrease gradually. This period of time is fraught with various complications, such as pneumonia, heart attack, sepsis, fractures of vertebral bodies, muscle contractures.
Also read the symptoms and treatment of diphtheria.
Diagnostics
A scrupulous collection of anamnesis is an early diagnosis of tetanus. In the case of this pathology, laboratory data are of secondary importance, because exotoxin in the blood can not be detected and there are no abnormalities.
Only for tetanus is the combination of trism, "sardonic smile", dysphagia( classical triad), as well as aching pains around healed wounds, and stiff neck muscles.
Therefore, the diagnosis is based on clinical indicators. Characteristic is also the absence of abnormalities from the internal organs.
Treatment of tetanus
Treatment takes place in the intensive care unit under the supervision of an anesthesiologist. Complex treatment and treatment of tetanus in humans implies:
- exclusion of external stimuli.
- examination and wound treatment.
- introduction of serum to neutralize toxin.
- fighting cramps by reducing the tone of skeletal muscle.
- tracheotomy, artificial lung ventilation, or intubation if respiratory distress occurs.
- support of vital functions.
- prevention of complications with the use of antibiotics.
- full nutrition( feeding through the probe).
- 24-hour monitoring of medical personnel.
Prevention of tetanus
Preventive measures are carried out in several directions. There is a nonspecific, specific and emergency prophylaxis of tetanus.
- 1) Nonspecific prevention is a health education among people, which is aimed at preventing injuries, both in domestic conditions and production.
- 2) Specific prophylaxis is performed on a schedule of vaccinations through the introduction of tetanus vaccine. It is shown to all children, starting from the age of 3 months. After finishing the course of immunization, the human body can produce antitoxins for another decade. Accordingly, revaccination should be carried out every 10 years.
- 3) Emergency prophylaxis is prescribed for injuries of the skin, injuries, burns, animal bites, frostbite, for community labor, and also for operations on the intestines. It consists in the treatment of the wound, specific immunoprophylaxis and should be carried out no later than 20 days after the injury.