Tetanus

Tetanus is an acute infectious disease characterized by severe toxic damage to the nervous system with tonic and clonic convulsions, thermoregulatory disorders.

Etiology, pathogenesis. Pathogen - a large stick, anaerobic; Forms spores, produces exotoxin. Often found in the soil. Disputes of the pathogen penetrate into the human body with various injuries, often minor damage to the skin, especially the lower extremities. Under anaerobic conditions, spores are transformed into vegetative forms, which begin to multiply and release exotoxin, which causes damage to the anterior horns of the spinal cord.

Symptoms, course. The incubation period is from 3 to 30 (usually 7-14) days; With a short incubation period, the disease is much more difficult. The disease begins with unpleasant sensations in the wound area (pulling pains, twitching muscles around it). The most characteristic symptom is the appearance of seizures. Early there is a convulsive contraction of chewing muscles (trismus), and also mimic muscles. Tonic contraction of muscles is replaced by attacks of clonic seizures, the muscles of the back, limbs are captured, opisthotonus arises. Cramps are provoked by the slightest external irritations. A convulsive contraction of the respiratory muscles, diaphragm and larynx muscles can lead to death of the patient from asphyxia. Characterized by headache and muscle pain, fever, excessive sweating, drowsiness, weakness.

Complications: pneumonia, muscle rupture, compression fracture of the spine. Tetanus should be differentiated from hysteria, tetany, strychnine poisoning, rabies, meningitis.

Treatment is carried out in specialized tetanus centers. The patient is transported by a doctor called from such a center. Before transportation, a neuroleptic mixture is introduced with the following composition: 2.5% aminazine solution - 2 ml, 2% pantopone solution - 1 ml, 2% dimedrol solution - 2 ml, 0.05% scopolamine solution - 0.5 ml. After 30 minutes in / m injected 5-10 ml of a 10% solution of hexenal or thiopental. For treatment in the first 2-3 days, injected into / m antitetanus serum of 100 000-150 000 ME (better anti-tetanus gamma globulin). Neuroleptic mixture is administered 3-4 times a day. To reduce seizures, prescribe chloral hydrate in enemas (50-150 ml of 3-5% solution).

In tetanus centers, a complex of resuscitation measures is carried out (total muscle relaxation in combination with artificial ventilation of the lungs, etc.).

The prognosis is serious.

Prevention. Scheduled immunization with tetanus toxoid. Fighting injuries. In case of trauma (burns, bites, skin and mucous membranes), 1 ml of the adsorbed toxoid is injected first, and after 30 minutes with another syringe and into another part of the body, 3000 IU of tetanus antiserum. Previously immunized. Against tetanus, only 0.5 ml of adsorbed anatoxin are administered to persons. The patient does not present any danger to the surrounding people. There are no events in the outbreak.