Medical history (history of illness) is an important component in the diagnosis of tetanus (lockjaw). Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms have you noticed? Painful, persistent muscle spasms, usually beginning at the temporomandibular joint (lockjaw)* . Twitching muscle spasms* Muscle stiffness – confined to one area or spreading … Tetanus: Medical History
Infectious and parasitic diseases (A00-B99). Rabies (Rabies, Lyssa). Psyche – Nervous System (F00-F99; G00-G99). Encephalitides (inflammation of the brain), unspecified. Meningitides (meningitis), unspecified Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99) Acute abdomen – severe abdominal pain with unclear cause. Tetany – disturbance of motor function and sensitivity due to hyperexcitability of … Tetanus: Or something else? Differential Diagnosis
The following are the major diseases or complications that may be contributed to by tetanus (lockjaw): Respiratory system (J00-J99) Pneumonia (pneumonia) Endocrine, nutritional, and metabolic diseases (E00-E90). Elevated catecholamine levels with blood. Skin and subcutaneous (L00-L99) Decubitus (bedsore) Cardiovascular system (I00-I99) Arrhythmias (cardiac arrhythmias). Blood pressure fluctuations Thrombophlebitis – inflammation of the superficial veins. Thrombosis … Tetanus: Complications
The following intensive medical measures are usually required. Ventilation Parenteral nutrition carried out bypassing the gastrointestinal tract. Heparingabe drug for thinning the blood Constant monitoring of laboratory parameters and body functions.
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. Bacteriology – wound culture – examination of wound swabs for germs. Creatine kinase (CK) – muscle enzyme – may be elevated. Myoglobin – muscle enzyme – may be elevated. Tetanus antitoxin (only suitable for checking the immunity situation)Tetanus antitoxin: … Tetanus: Test and Diagnosis
Therapeutic targets Elimination of the pathogens Avoidance of complications Therapy recommendations In addition to drug therapy (tetanus immunoglobulin; antibiotic: metronidazole, agent of first choice), surgical wound care (= thorough surgical rehabilitation of the wound) must always be performed. Postexposure prophylaxis [see below]. See also under “Further therapy“. Postexposure prophylaxis (PEP) Post-exposure prophylaxis is the provision … Tetanus: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnosticsand obligatory medical device diagnostics – for differential diagnostic clarification. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – for suspected cardiac arrhythmias. X-ray of the chest (X-ray thorax/chest), in two planes – if cardiopulmonary (heart–lung) complications … Tetanus: Diagnostic Tests
Operative measure – 1st order Thorough surgical sanitation of the wound.
Physiotherapy adjunctive measures are always required: Contracture prophylaxis – to prevent the permanent shortening of muscles that lead to severe limitation of mobility. For more information, see physiotherapy
Tetanus vaccination is the most important and effective preventive measure. Furthermore, to prevent tetanus, attention must be paid to reducing risk factors. Behavioral risk factors Contact of wounds with contaminated soil. Insufficient protection by vaccination Not hygienic care of the umbilical cord in the newborn. Post-exposure prophylaxis (PEP) Post-exposure prophylaxis is the provision of medication … Tetanus: Prevention
The following symptoms and complaints may indicate tetanus (lockjaw): Leading symptoms Painful tonic – persistent muscle spasms, usually starting at the temporomandibular joint – trismus – lockjaw. Clonic – twitching muscle spasms. Rigidity (muscle stiffness) – confined to one area or spreading from the shoulder region. Amplification of cramps under the influence of external stimuli. … Tetanus: Symptoms, Complaints, Signs
Pathogenesis (disease development) The bacterium Clostridium tetani is ubiquitous in the soil, as well as in the intestines of humans and animals. If contact with Clostridium tetani occurs via a wound, the bacterium enters the body and forms toxins (poisons) for the body. In particular, the toxin tetanospasmin is significant because it travels along nerve … Tetanus: Causes
