8. Tetanus

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9 Terms

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Agent and source?

Clostridium tetani Spores in soil and animal faeces

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Toxin and action?

Tetanospasmin: retrograde axonal transport Blocks GABA/glycine release → spastic paralysis

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Clinical signs?

Trismus (lockjaw), risus sardonicus, opisthotonus Neonatal tetanus (umbilical stump)

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  1. Specimen?

Wound tissue / exudate But diagnosis is clinical; culture is rarely positive

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  1. Microscopy?

Gram+ slender rods with round terminal spores — "drumstick" Möller spore stain

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  1. Cultivation?

Strict anaerobe: Kitt–Tarozzi, blood agar anaerobically Swarming growth

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  1. Identification?

Toxin neutralisation test in mice (classical) PCR for toxin gene

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  1. Treatment?

Human tetanus immunoglobulin 500 IU Wound debridement + metronidazole Muscle relaxants / ICU; then give toxoid

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Prophylaxis?

Tetanus toxoid (DTaP; Td every 10 years) Wound: Td ± HTIG 250 IU depending on wound and vaccine hist