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Identification C. tetani is a rod-shaped, endospore-forming, anaerobic soil bacterium responsible for an estimated 200 cases of tetanus (spastic paralysis) every year in the U.S. and an additional 350,000 worldwide. Pathogenesis The organism is found in soil, animal faeces and, occasionally, human faeces. Spores are often deposited in dead (oxygen-free) tissue through a wound, burn, or ulcer. The lesion of infection often goes unnoticed allowing spores to germinate and spread long before treatment can be obtained. By secreting a powerful neurotoxin, tetanospasmin, C. tetani blocks the release of neurotransmitters from the presynaptic membranes of inhibitory nerve synapses. The toxin can be up to 10% of the bacterial weight. Manifestations Tetanus has been known to take up to ten years to manifest, but normally, incubation period is a few days to a few weeks. The first signs of the disease include mild muscle contractions at the site of infection as the infection gradually spreads along nerve fibers to the spinal cord and brain stem. Trismus (lockjaw) ensues with continued rigidity and spasms of the extremities. Death occurs when spasms interfere with respiration. Treatment If treatment is not sought early, the disease is often fatal. Treatment includes administration of antibiotics, deliverance of antitoxin, and surgery. Prevention Immunity to the tetanus toxin is provided by a vaccine of inactivated formaldehyde-treated toxin. Boosters are recommended every 7-10 years. |
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