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Clostridium tetani

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Clostridium tetani 

  • Characteristics
    • Common to all bacteria in Clostridia family
    • Gram + rods
    • Obligate anaerobic
    • Spore-forming
  • Produces tetanospasmin (toxin)
    • Blocks release of GABA and glycine (inhibitory neurotransmitters) in spinal neurons that regulate motor neurons
      • Removal of inhibition causes increased muscle activation (spasms)
  • Exposure
    • Trauma (piercing/puncture wound)
      • Occurs in people who have not be vaccinated
  • Presentation: tetanus
    • trismus (lockjaw)
    • sardonic smile
      • Also called risus sardonicus (raised eyebrows and open grin)
    • muscle spasms
      • Includes opisthotonos (spasms of spinal extensors)
    • irritability
    • neonatal tetanus 
      • colonization of the umbilical stump in neonates born to unvaccinated mothers
      • inability to suck or cry after day 2 of life
  • Treatment
    • Prevent with tetanus toxoid vaccine
      • Elicits humoral (antibody) immunity to tetanus toxin (tetanospasmin)
      • More common in developing countries due to low rates of vaccination 
    • Antitoxin +/- vaccine booster
      • For patients with contaminated or dirty wounds 
    • Antibiotics
    • Benzodiazepines (diazepam) for muscle spasms
    • Wound debridement