Tetanus or tetanus - an acute-toxic microbial infection that occurs as a result of exposure to specific toxins tetanus bacillus on the nervous system and muscles to their defeat.
Tetanus is manifested in severe spasmodic contractions of striated and smooth muscles of the body with the adoption of typical tetanus poses. The disease is difficult, giving deaths in the case of the running course, which is why conducted mass vaccination of the population against tetanus.
Causes
The main causative agent is Clostridium tetanus, which refers to the spore-forming bacteria. The bacterium is highly resistant to external conditions, long-stored in the external environment, and resistant to disinfectants and standard solutions. Tetanus bacillus spores in a favorable environment secrete specific toxins.
High incidence of tetanus in hot countries where the worse wounds heal, and above the soil contaminated with the causative agent. The incidence rate depends on the level of vaccination, and 80% of patients - a newborn with a special form of neonatal tetanus from the umbilical wound infection as a gateway.
Tetanus is associated with extensive and contaminated wounds, as well as small household injuries - cuts, burns, injections with dirty instruments.
Kinds
secrete
- Adult tetanus,
- neonatal tetanus (umbilical tetanus),
- Local tetanus,
- neyrostolbnyak,
- Parent (bulbar) tetanus.
symptoms of tetanus
The incubation period of tetanus lasts about 1-2 weeks, in rare cases, extended up to a month.
Thus tetanus symptoms occur after wound healing, in which fall bacilli. The shorter the incubation period, the harder it will be for the disease.
The disease begins acutely, against the background of well-being, but it may be preceded by general symptoms - lethargy, irritability, fatigue.
The first key symptom of tetanus - lockjaw is the masticatory muscles (convulsive their stress with a very difficult opening of the mouth). At the beginning of such a disease symptom is detected physician using special methods, then it arises spontaneously.
Next, begin to show the classic symptoms:
- sardonic smile due to spasm of the facial muscles,
- dysphagia (difficulty swallowing), due to spasmodic contraction of muscles of the pharynx and esophagus,
- muscle involvement from the top down, especially pronounced in the extensor muscles,
- stiff neck muscles tilting the head, over-extension of the spine with subsidence arc and extending limbs,
- disturbed breathing with the defeat of the diaphragm and intercostal muscles,
- there are severe pain in the muscles,
- tonic convulsions of any stimuli (light, sound, touch) with fever, sweating, salivation and muscle spasms crotch difficulties physiological functions,
- against the background of defeats mind remains clear, there are no changes in the internal organs.
Diagnostics
The diagnosis of tetanus exhibited clinical symptoms, as the laboratory does not have symptoms of paramount importance.
The toxin can not always be identified at an early period, and the detection of antibodies to tetanus vaccinations may be due to earlier. antibodies to the toxin increase may be negligible even at doses of lethal toxin formation. Sometimes it may be used smear microscopy, histology tissue obtained from surgery on infected wounds.
Basis of diagnosis - collecting history of infected wounds, there is twitching in the muscles, pain in the muscles.
Differential diagnosis should be done with rabiesSince similar symptoms can be in the initial period and from him. Similar to the tetanus can be poisoned with strychnine, tetany in lesions of the thyroid gland, as well as brain and spinal cord damage.
treatment of tetanus
Tetanus patients treated resuscitators and infectious disease in intensive care units of hospitals.
In order to ensure peace create a subdued light and quiet, full of peace.
To neutralize the tetanus toxin administered tetanus-specific immunoglobulins or serum. In convulsions appointed sedatives, anticonvulsants (sibazon, seduksen) anesthetize narcotic analgesics (tramadol, morphine), muscle relaxants administered, neuroplegic drugs.
At disturbances of breathing is conducted connection to the ventilator support life support devices are assigned to laxatives, the catheter into the bladder.
Antibiotics tetracycline class, pouring reopoligljukin, gemodez, plasma and albumin. Patients require very careful care.
Vaccination against tetanus
Children are vaccinated against tetanus fivefold. The first vaccination is done in 3 months, followed by 4.5 months., In six months, 1.5 years, and then 6-7 years.
adult revaccination is carried out at the age ranging from 18 years old. If a child was held a full course of tetanus vaccination, then, only one inoculation in 10 years. In primary adult vaccination, put 2 immunizations at monthly intervals, and a year later another.
Grafting is placed intramuscularly (normally under vane shoulder or hip).
After inoculation possible side effects: swelling at the site of inoculation, moderate pain, fever (it is allowed to churn antipyretics). All these symptoms should normally take place within 2-3 days.
To be vaccinated against tetanus and get detailed advice at any clinic in the community.
Complications and prognosis
Often a complication of tetanus is pneumoniaSince it contribute to respiratory failure and stagnation of the contents, violation of the drainage function of bronchi.
Muscle cramps can lead to bone fractures, vertebral bodies, tearing of muscles and ligaments, muscle contractures are formed.
Prognosis in young children is extremely unfavorable, children die. In adults, depending on the type of tetanus, of the duration and severity of the infection, the illness lasts an average of two weeks to six weeks.
