TETANUS


  1. Caused by Clostridium Tetani, GM+ rod, obl. anaerobe, "terminal spore-forming"
  2. Incubation period 24h-100days
  3. Produces a neurotoxin ("tetanospasmin") which travels along perineural sheath and affects ant. horn cells
  4. Signs: begins with nonspecific febrile illness, myalgia, malaise; later, get trismus, convulsions (often deadly) after about 72h
  5. Diff: meningitis, status epilepticus, strychnine poisoning
  6. Back musc. tetany can cause vertebral fxx. and secondary SC damage; asp. pneumonia can occur
  7. Tx: PCN, expose wound to AIR; keep pt in DARK, QUIET room, give TPN if nec.; IV VALIUM