Clostridium tetani is a bacterium in the Clostridia family and the causative agent of the disease tetanus. Tetanus, also called lockjaw, is a wound infection that is often fatal.
What is Clostridium tetani?
The bacterium Clostridium tetani is found in the intestines of animals (especially herbivores) and humans. The dangerous spores of the pathogen are spread almost everywhere, e.g., in garden soil or even road dust. The bacterial spores enter the body primarily through deep and air-sealed wounds, such as stepping on a rusty nail. But even the smallest skin injuries, e.g. caused by a splinter of wood, can be a portal of entry for Clostridium tetani. The source of infection for the so-called neonatal tetanus is the umbilical wound, when the newborn is aborted under non-sterile conditions. Neonatal tetanus usually occurs only in developing countries and shows the highest lethality of all forms of tetanus. The World Health Organization estimates that about 180,000 babies die of tetanus worldwide.In Germany, fewer than 15 people contract tetanus each year. Transmission from person to person is not possible. Once the pathogen Clostridium tetani has entered the body, it takes a few days to two weeks, in rare cases even a few months, for the first symptoms to appear. The following applies: the shorter the incubation period, the more severe the course of the disease.
Significance and function
Under anaerobic conditions, i.e., when there is a lack of oxygen in the wound, the spores of Clostridium tetani germinate, the bacterium multiplies, and forms two toxins that are very dangerous to the body: tetanospasmin and tetanolysin. Via the bloodstream or nerves, the toxin tetanospasmin reaches the spinal cord. There it causes hypersensitivity, increased reflexes and convulsions. The toxin tetanolysin damages the blood and the heart muscle. As a result of this exposure to the toxins, various symptoms occur. Initially, sufferers tend to show general symptoms such as headache, backache, muscle pain, and fatigue. In addition, feelings of tension in the wound area, sensitivity to light and noise, and inner restlessness may occur. In mild courses of the disease, this is followed by localized muscle stiffness, especially in the jaw and neck area. However, seizures do not occur. In more severe infections with Clostridium tetani, the above-mentioned muscle stiffness also initially appears in combination with high fever. However, this is followed by convulsions of the muscles. Initially, the masticatory muscles, the tongue muscles and the mimic muscles spasm. Due to the spasm of facial muscles, patients show the so-called sneer or devil’s grin. This is followed by spasms of the neck muscles, extremities and abdominal muscles. Sufferers usually freeze in an extended position. The spasms are triggered by even the slightest visual or acoustic stimuli. During these very painful seizures, affected individuals are fully conscious.
Diseases
Possible complications of Clostridium tetani infection include pneumonia, muscle tears, bone dislocations, and bone fractures (caused by the seizures), as well as possible residual muscle shortening, joint stiffness, and spinal curvature. Death occurs either by suffocation caused by paralysis of the tongue, pharynx, larynx, or diaphragm muscles, or by cardiovascular failure. In the severe form, 50% of all Clostridium tetani infections are fatal despite vaccination. Without vaccination, the lethality in the severe form is 90%. The early administration of an antitoxin is crucial. Patients receive intensive medical care. With the help of sedatives, muscle-relaxing drugs and artificial respiration, the patients are given relief. If possible, patients are accommodated in a soundproof and darkened room to prevent seizures. Recovery after surviving infection with Clostridium tetani takes only a few days in mild cases. In severe cases, convalescence may take several weeks to months. An illness with tetanus does not leave sufficient antibodies, so that a new illness is possible. A possible protection against an infection with Clostridium tetani is offered by a tetanus vaccination.In infancy and toddlerhood, a basic immunization is usually carried out, which must then be refreshed every 10 years. In particular, persons over 60 years of age should pay attention to their vaccination protection, since with increasing age the antibodies against the bacterium are broken down more quickly.
