Tetanus

Multisystem Processes & Disorders


Clinicals - History

Fact Explanation
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Tetanus is a disease that affects the nervous system. It is characterized by muscle spasms due to the tetanospasmin toxin released by Clostridium tetani. C. tetani is an anaerobic bacterium that is commonly found in the soil."}]}
{"ops":[{"insert":"Tetanus-prone wounds"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of puncture type wounds, contamination with dirt or manure, sepsis, burns, high-velocity missile injuries, or frostbite increases the risk of tetanus. Also, any wound over six hours old should be considered tetanus-prone."}]}
{"ops":[{"insert":"Trismus"},{"insert":"\n"}]}
{"ops":[{"insert":"Spasms involving the masseter and temporal muscles may result in trismus, also known as lockjaw, which is an inability to open the mouth. This occurs when C. tetani reaches the spinal cord and brainstem via retrograde axonal transport. Then, the release of tetanospasmin causes defects in the anterior horn inhibition of muscular contraction. The result is involuntary, sustained muscle contraction."}]}
{"ops":[{"insert":"Muscle rigidity"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients present with prolonged, tonic contraction of involved muscle groups. This occurs due to the inhibition of inhibitory neuromuscular signaling from the anterior horn."}]}
{"ops":[{"insert":"Muscle spasms"},{"insert":"\n"}]}
{"ops":[{"insert":"Muscle \u0022spasms\u0022 are short-lasting muscle contractions. They may be elicited from movements or sensory stimuli. These reflex spasms occur due to hyperactivity of the lower motor neurons due to denervation."}]}
{"ops":[{"insert":"Dysphagia"},{"insert":"\n"}]}
{"ops":[{"insert":"The involvement of the muscles of the tongue, pharynx, and esophagus can lead to difficulty swallowing. This occurs due to the inhibition of inhibitory neuromuscular signaling from the anterior horn."}]}
{"ops":[{"insert":"Opisthotonus"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients with generalized tetanus may present with arching of the back due to involvement of the dorsal extensor muscles."}]}
{"ops":[{"insert":"Apnea\/upper airway obstruction"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may present with shortness of breath due to involvement of the respiratory and laryngeal muscles."}]}
{"ops":[{"insert":"Pain"},{"insert":"\n"}]}
{"ops":[{"insert":"Pain in tetanus occurs due to severe spasms. Atypically, pain and allodynia can occur due to the involvement of sensory nerves."}]}
{"ops":[{"insert":"Duration"},{"insert":"\n"}]}
{"ops":[{"insert":"The initial symptoms of tetanus usually occur around ten days after an inoculating trauma. However, the incubation period may range from three days to three weeks."}]}
{"ops":[{"insert":"Localized tetanus"},{"insert":"\n"}]}
{"ops":[{"insert":"Localized tetanus is a less common form of the disease characterized by spasm of muscles directly adjacent to the wound site. This presentation may precede generalized disease."}]}
{"ops":[{"insert":"Cephalic tetanus"},{"insert":"\n"}]}
{"ops":[{"insert":"Cephalic tetanus is characterized by trismus, eyelid retraction, dysphagia, deviated gaze, and risus sardonicus. This presentation is caused by involvement of the bulbar musculature."}]}
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Tetanus is a disease that affects the nervous system. It is characterized by muscle spasms due to the tetanospasmin toxin released by Clostridium tetani. C. tetani is an anaerobic bacterium that is commonly found in the soil."}]}
{"ops":[{"insert":"Tetanus-prone wounds"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of puncture type wounds, contamination with dirt or manure, sepsis, burns, high-velocity missile injuries, or frostbite increases the risk of tetanus. Also, any wound over six hours old should be considered tetanus-prone."}]}
{"ops":[{"insert":"Trismus"},{"insert":"\n"}]}
{"ops":[{"insert":"Spasms involving the masseter and temporal muscles may result in trismus, also known as lockjaw, which is an inability to open the mouth. This occurs when C. tetani reaches the spinal cord and brainstem via retrograde axonal transport. Then, the release of tetanospasmin causes defects in the anterior horn inhibition of muscular contraction. The result is involuntary, sustained muscle contraction."}]}
{"ops":[{"insert":"Muscle rigidity"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients present with prolonged, tonic contraction of involved muscle groups. This occurs due to the inhibition of inhibitory neuromuscular signaling from the anterior horn."}]}
{"ops":[{"insert":"Muscle spasms"},{"insert":"\n"}]}
{"ops":[{"insert":"Muscle \u0022spasms\u0022 are short-lasting muscle contractions. They may be elicited from movements or sensory stimuli. These reflex spasms occur due to hyperactivity of the lower motor neurons due to denervation."}]}
{"ops":[{"insert":"Dysphagia"},{"insert":"\n"}]}
{"ops":[{"insert":"The involvement of the muscles of the tongue, pharynx, and esophagus can lead to difficulty swallowing. This occurs due to the inhibition of inhibitory neuromuscular signaling from the anterior horn."}]}
{"ops":[{"insert":"Opisthotonus"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients with generalized tetanus may present with arching of the back due to involvement of the dorsal extensor muscles."}]}
{"ops":[{"insert":"Apnea\/upper airway obstruction"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may present with shortness of breath due to involvement of the respiratory and laryngeal muscles."}]}
{"ops":[{"insert":"Pain"},{"insert":"\n"}]}
{"ops":[{"insert":"Pain in tetanus occurs due to severe spasms. Atypically, pain and allodynia can occur due to the involvement of sensory nerves."}]}
{"ops":[{"insert":"Duration"},{"insert":"\n"}]}
{"ops":[{"insert":"The initial symptoms of tetanus usually occur around ten days after an inoculating trauma. However, the incubation period may range from three days to three weeks."}]}
{"ops":[{"insert":"Localized tetanus"},{"insert":"\n"}]}
{"ops":[{"insert":"Localized tetanus is a less common form of the disease characterized by spasm of muscles directly adjacent to the wound site. This presentation may precede generalized disease."}]}
{"ops":[{"insert":"Cephalic tetanus"},{"insert":"\n"}]}
{"ops":[{"insert":"Cephalic tetanus is characterized by trismus, eyelid retraction, dysphagia, deviated gaze, and risus sardonicus. This presentation is caused by involvement of the bulbar musculature."}]}

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