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  Pathogenesis of Tetanus

Pathogenesis of Tetanus :

Tetanus takes place generally as the outcome of contaminated wound with C. tetani spores. When washed spores are injected into an animal they fail to germinate and are eliminated by phagocytosis. Germination of the spores depends on reduced oxygen tension taking place in devitalized tissues and non-viable material in the wound. Infection is localized, tetanic situation takes place due to the toxin. Tetanus toxin does not cause death of the adjacent tissues and does not bring around the spread from its primary focus. Situations of tetanus have been reported from superficial scrape or a minor thorn prick. Gardening enthusiasts form one of the acknowledged risk groups. Otogenic tetanus (i.e., infection of the external auditory meatus), cryptogenic tetanus (i.e., site of infection undiscovered), uterus tetanus, tetanus neonatorum (i.e., infection of the umbilical wound of new born infants) and post operative tetanus have been report.

Clinical Features of Tetanus:

Symptoms begin with some stiffness and pain in or close to the recent wound. In some situations the initial complaint might be of stiffness of the jaw (i.e., Lock jaw). Pain and firmness in the neck and back might follow. The stiffness spreads to include all muscle groups. Facial spasms generate the ‘sporadic grin’ and in some situations spasm of the back muscles generates the opisthotonos (i.e., extreme arching of the back). It takes 10 to 14 days between the injury and the initial sign and it also might vary. Sweating, arrhythmia, tachycardia, and swings in blood pressure might also be seen.

Laboratory Diagnosis:

Specimens from wounds are gathered and Gram stained. The smear exhibits characteristic Gram positive drum stick shaped bacilli. They might confuse with other bacilli with terminal spores. Simple microscopy might not be helpful; immuno fluorescence microscopy with a special stain might be effectual though not usually available. Direct culture of the unheated material on blood agar must be incubated anaerobically. Specimen from wound must be heated at differing temperatures for different spore forming organisms. Tetanus might be generated in mice by sub-cutaneous infection of the anaerobically grown culture. Control mice are protected with tetanus antitoxin.

 

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