Clostridium tetani
From IDWiki
Background
- Ubiquitous soil organism
- Acquired either by direct inoculation or via umbilical stump in neonates
Pathophysiology
- Toxin blocks inhibitory interneurons in the spinal cord and autonomic nervous system
Clinical Manifestations
- Incubation period of 3 to 21 days
- Followed by generalized tetanus, with tetanic spasms with even minimal external stimulus
- Lockjaw, risus sardonicus, opisthotonus, abdominal rigidity, and eventually apnea
Prognosis and Complications
- 30% mortality
- Can cause bony fractures, asphyxia, hematomas, and rhabdomyolysis
Diagnosis
- Baseline IgG serology; if positive, then they are tetanus-immune and it rules out the diagnosis
- Send wound swab or tissue for culture or PCR
Management
- Tetanus antitoxin or IVIg
- Wound care with debridement
- Antibiotics
- Vaccination on recovery
