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 At the end of this presentation the students will be able to:

 Define Tetanus Toxiod.

 Explain pathophysiology and Causes.

 Describe Sign and symptoms.

 Explain types and Diagnostic finding.

 Describe medical, and nursing management of tetanus

 Tetanus, also called lockjaw, is a serious infection caused
by Clostridium tetani. This bacterium produces a toxin
that affects the brain and nervous system, leading to
stiffness in the muscles. If Clostridium tetani spores are
deposited in a wound, the neurotoxin interferes with
nerves that control muscle movement.
Causative agent
 Clostridium tetani
 Tetanus is caused by an
infection with the bacterium
Clostridium tetani, which is
commonly found in soil,
saliva, and dust. The bacteria
generally enter through a
break in the skin such as a cut
or puncture wound by a
contaminated object.
 .
Sign and Symptoms
 Common signs and symptoms of tetanus include:
 Spasms and stiffness in jaw muscles (also called lock jaw)
 Stiffness of neck muscles
 Difficulty swallowing
 Stiffness of abdominal muscles
 Fever
 Sweating
 Painful body spasms lasting for several minutes, typically
triggered by minor occurrences, such as loud noise,
physical touch or light
Types of tetanus


 Persistent muscle contractions in the same anatomic area

as the injury, which will however subside after many
weeks; very rarely fatal.


 Occurs with ear infections or following injuries of the

head; facial muscles contractions.
Common types:
- descending pattern: lockjaw  stiffness of neck 
difficulty swallowing  rigidity of abdominal and back
- Spasms continue for 3-4 weeks, and recovery can last for
- Death occurs when spasms interfere with respiration.
- Form of generalized tetanus that occurs in newborn
infants born without protective passive immunity because
the mother is not immune.
- Usually occurs through infection of the unhealed umbilical
stump, particularly when the stump is cut with an unsterile
Methods of diagnosis
 Based on the patient’s account and physical findings that
are characteristic of the disease.

 Diagnostic studies generally are of little value, as cultures

of the wound site are negative for C. tetani two-thirds of
the time.
 When the culture is positive, it confirms the diagnosis of

 Tests that may be performed include the following:

 Culture of the wound site (may be negative even if
tetanus is present)
 Tetanus antibody test
 Other tests may be used to rule out meningitis, rabies,
or other diseases with similar symptoms.
Clinical treatment
 Tetanus is typically treated with a variety of therapies and
medications, such as:
 antibiotics such as penicillin to kill the bacteria in your system
 tetanus immune globulin (TIG) to neutralize the toxins that the
bacteria have created in your body
 muscle relaxers to control muscle spasms
 a tetanus vaccine given along with the treatment
 cleaning the wound to get rid of the source of the bacteria
 In some cases, a surgical procedure called debridement is used
to remove dead or infected tissue. If you have difficulty
swallowing and breathing, you may need a breathing tube or
ventilator (a machine that moves air in and out of the lungs).
Nursing management
 Provide complete bed rest to the patient.
 Keep the patient in dim lighted, quite and well ventilated
room as spasm can be stimulated by bright light, noise or
even touch.
 Fluid and electrolytes balance should be maintained.
 Due to spasm and increased muscle activity patient need
extra high calorie and protein diet.
 Change patient position every 2 hourly to prevent bed
 care of wound such as removal of necrosed tissue, cleaning
with hydrogen peroxide and treatment with antibiotic
ointment is done.

 Breslow, Lester. (2002). “Tetanus.” Encyclopedia of Public

Health. New York : Macmillan Reference USA/Gale Group
Thomson Learning.
 Lederberg, J. (2003) Clostridia. Encyclopedia of
Microbiology. New York, NY: Academic Press. 1, 834-839.
 Olendorf, D., et al. (1999).“Tetanus.” The Gale encyclopedia
of medicine. Detroit : Gale Research.