Tetanus or tetanus is the name given to an infectious disease that is known primarily for its onset of paralysis. Primarily, various strains of bacteria are responsible for the wound infection, which can spread through the wound as it progresses.
What is wound tetanus?
Infographic on the symptomatology of tetanus. Click to enlarge. Tetanus, also known as lockjaw, is an infectious disease. In this case, bacteria enter the bloodstream through a contaminated wound. A toxin then causes the muscles to cramp. This leads to paralysis. There are several types of tetanus. The most common worldwide is neonatal tetanus. Newborns can contract it. Those affected by this form are predominantly found in countries where medical care is inadequate. In Central Europe, generalized tetanus is the most common form of tetanus. After childbirth, mothers may suffer from puerperal tetanus, which occurs due to infection of the uterus. Infection of surgical wounds can also lead to tetanus. This is postoperative tetanus. If the paralysis is limited to only one part of the body, it is local tetanus. A special form of it is cephalic tetanus, which is caused by injuries in the head area. 30% of all sufferers die from tetanus if it is not treated.
Causes
A contaminated wound is the most common cause of tetanus. A certain bacterium called Clostridium tetani must enter the body to cause the tetanus infection. This then releases a toxin. If the environment is low in oxygen, the bacterium can reproduce. The bacterium prefers to find this environment in open wounds. Tetanus can occur worldwide, as it is a natural part of the human body and environment. By forming spores, the pathogen can protect itself from unfavorable influences of its environment. Its genetic data is then unassailable, however, it can no longer reproduce in this way.
Symptoms, complaints, and signs
The first symptoms are rather nonspecific. They manifest themselves in a general feeling of illness with headache, fatigue and dizziness. As the condition progresses, muscles begin to ache and feel unusually stiff. Particularly in the face and neck, these muscle aches become noticeable and affect facial expressions. This can lead to strange grimaces. Over time, swallowing disorders and a cramping of the chewing muscles are added. The latter causes locking of the mouth or jaw, the characteristic symptom of the disease. The laryngeal muscles may also be affected by the spasms, making it impossible for patients to speak. They sweat, their blood pressure rises, and a certain irritability and restlessness sets in. Heart palpitations (tachycardia) are possible. In some cases, fever and chills occur. As the disease progresses, muscle spasms spread to the entire body and violent cramps occur in the abdominal and back muscles. These cramps can be so severe that the body assumes a posture that is completely different from the norm, causing vertebral bones to fracture. The muscles of organs such as the bladder or intestines may also be affected, making defecation and urination impossible. If the disease is not treated, it usually leads to death due to respiratory paralysis.
Course of the disease
The first symptoms of tetanus are pain in the head and muscles (muscle aches, dizziness, and sweating. Jaw pain and a permanent grin due to facial muscle spasm may also be symptoms of the initial stage. Paralysis occurs from the head down. The painful spasms of tetanus can occur every minute. They are triggered by stimuli. After the head, the back and abdomen become paralyzed. This is followed by the limbs. If spasms occur in the abdomen and back, they can lead to fractures of the spine. The final stage of paralysis involves the larynx and diaphragm. Should the latter spasm, respiratory distress occurs. The patient may die from lack of air. The disease is accompanied by high fever (over 40 degrees Celsius), which can lead to death under untreated circumstances.Tetanus toxin, the toxin that causes tetanus, can be detected in a laboratory, which helps to make a definitive diagnosis at the beginning of the disease process.
Complications
If tetanus progresses untreated, the convulsions spread to other parts of the body. A typical sequelae is a condition called lockjaw or trismus, which is usually accompanied by spasming facial and tongue muscles. The spasms eventually spread to the muscles of the arms and legs, ribs, larynx and diaphragm. Muscle rigidity of the long muscles of the back and abdomen occurs, as a result of which the affected person can hardly move. In most cases, tetanus is accompanied by other symptoms, such as high fever, vertebral injuries and breathing difficulties. If the diaphragm is involved, there is an acute risk of suffocation. Furthermore, tetanus can affect the autonomic nervous system and cause functional disorders. This sometimes leads to palpitations, sweating and circulatory disorders in the arms and legs, which in the absence of treatment or inadequate treatment can lead to further complications. The therapy also carries risks. In addition to the usual side effects and interactions that antibiotics, tetanus immunoglobulin, and muscle relaxants can cause, there may be secondary infections (during surgical treatment of the wound) and psychological distress as a result of prolonged hospitalization.
When should you go to the doctor?
If the affected person notices a decrease in his well-being, experiences a feeling of illness or general malaise, a visit to the doctor is necessary. In the case of fatigue, dizziness and headaches, in most cases there is a health disorder that needs to be diagnosed. Disorders of the muscular system as well as cramps are an alarm signal of the organism. A doctor should be consulted so that medical tests can be performed to clarify the cause. If the swallowing process can no longer be performed without discomfort, there is cause for concern. If the affected person experiences a blockage of the mouth or jaw, the help of a physician should be sought immediately. If there is inner restlessness as well as irritability, a visit to the doctor is necessary. Disturbances of the heart rhythm, fever or chills must also be examined and treated. If there are complaints of respiratory activity, action must be taken as quickly as possible. In severe cases, an emergency situation occurs due to the impairments. If an acute health change develops, an emergency physician must be alerted. Persons present must take first aid measures until the doctor arrives. Otherwise, there is a risk of premature death. Adopting a protective posture should also be interpreted as a warning signal. If the affected person can no longer move as usual due to pain or cramps, he or she requires medical care.
Treatment and therapy
Once tetanus or lockjaw has broken out, there is no antidote for the tetanus toxin. The patient is treated only by relieving symptoms. The important thing here is to isolate the patient from stimuli. The best way to heal is in a dark, quiet room. The wound through which the pathogen entered the blood of the affected person must be thoroughly cleaned. The administration of a vaccine (tetanus vaccine) against tetanus is also important as a preventive measure, as it prevents the further spread of the toxin. Patients must be medically monitored around the clock. They are given medication to relax the muscles and antibiotics to strengthen the immune system. Even if the patient is treated, tetanus can lead to death. In this case, the death rate is up to 20%.
Prevention
Tetanus or tetanus is best prevented by vaccination. This gives it with mostly free of charge with the family doctor. Furthermore, wounds are to be kept clean by disinfection of germs and bacteria to avoid infection.
Aftercare
It can take up to three months for the physical effects of tetanus to completely resolve. Recovery can be promoted with comprehensive aftercare. Rest and plenty of rest are important at first, as the body is still very weakened at the beginning. Patients should refrain from physical exercise and in any case take a sick leave. At the same time, the symptoms must be monitored.The skin changes should have subsided after three weeks at the latest. During the follow-up examination, the physician checks the injection site and, if necessary, performs a blood test. If the course is positive, the patient can discontinue the antibiotics. After three months, the doctor should be consulted again. By this time, the symptoms should have completely subsided, as the toxin has been killed by the antibiotics in the meantime. If symptoms persist, a doctor should be consulted immediately. In case of cramps, complaints of the circulatory system or high fever, which also rises rapidly, the emergency doctor should be consulted. In a severe course, multiple organ failure and ultimately death of the patient will occur. Aftercare in this case is needed by the relatives, who can be provided with psychological support if necessary.
What you can do yourself
Tetanus must be clarified promptly by a physician. Until a doctor is seen, symptoms should be closely monitored and reported to the doctor. The medical professional must also be informed of the trigger so that a diagnosis can be made quickly. If available, the object that triggered the injury can be given to the physician. In addition, sufficient rest is recommended in the case of tetanus. Affected individuals should not exert themselves and should take it easy on the affected area. The area where the bacteria have penetrated the skin must be disinfected if possible. Adequate cooling is also recommended. After a tetanus vaccination, rest is recommended. Extreme stress should be avoided to ensure vaccination protection. The measures necessary in the case of tetanus depend on the symptoms. In any case, a doctor must be consulted immediately. Furthermore, the injury should be closely observed. Larger bleedings must be stopped. Tetanus can impair motor skills. Therefore, accompanying the alerting of the emergency physician, it must be ensured that the affected person remains calm and does not put himself in dangerous situations.
