1. Te t a n us
Daquioag, Deborah C.
Dizon, Jose Enrico C.
Primary Health Care
AAPD2F

2. What is Tetanus?
• An infectious disease caused by
contamination of wounds from the
bacteria Clostridium tetani, or the
spores they produce that live in the
soil, and animal feces
• Greek words -
“tetanosand teinein”, meaning rigid
and stretched, which describe the
condition of the muscles affected by
the toxin, tetanospasmin, produced
by Clostridium tetani

3. Causes
• Tetanus occurs when a wound becomes
contaminated with Clostridium tetani bacterial spores.
• Infection follows when spores become activated and
develop into gram-positive bacteria that multiply and
produce a very powerful toxin (tetanospasmin) that
affects the muscles.

4. Causes
• Tetanus spores are found throughout the
environment, usually in soil, dust, and animal waste.
• Tetanus is acquired through contact with the
environment; it is not transmitted from person to
person.

5. Causes
• The usual locations for the bacteria to enter the body:
– Puncture wounds (such as those caused by rusty
nails, splinters, or insect bites.)
– Burns, any break in the skin, and IV drug access sites are
also potential entryways for the bacteria.

6. Signs and Symptoms
• Tetanus often begins with mild spasms in the jaw
muscles (lockjaw). It can also affect the
chest, neck, back, and abdominal muscles. Back
muscle spasms often cause arching, called
opisthotonos.
• Sometimes the spasms affect muscles that help with
breathing, which can lead to breathing problems.
• Prolonged muscular action causes
sudden, powerful, and painful contractions of muscle
groups. This is called tetany. These episodes can
cause fractures and muscle tears.

7. Muscle Spasms (causedbyTetanus)

8. Signs and Symptoms
• Other symptoms include:
• Drooling
• Excessive sweating
• Fever
• Hand or foot spasms
• Irritability
• Swallowing difficulty
• Uncontrolled urination or defecation

9. Prevention
• Tetanus is completely preventable by
active tetanus immunization.
• Immunization is thought to provide
protection for 10 years.
• Begins in infancy with the DTaP series
of shots. The DTaP vaccine is a "3-in-1"
vaccine that protects against
diphtheria, pertussis, and tetanus. It is
a safer version of an older vaccine
known as DTP

10. Prevention
• Td vaccine or Tdap vaccine is used to maintain
immunity in those age 11 and older. Tdap vaccine
should be given once, prior to age 65, as a substitute
for Td for those who have not had Tdap. Td boosters
are recommended every 10 years starting at age 19.
• Older teenagers and adults who have sustained
injuries, especially puncture-type wounds, should
receive booster immunization for tetanus if more than
10 years have passed since the last booster.

11. Treatment
• Medical treatment has two aims:
– Limit growth and eventually kill the infecting C.
tetani and thus eliminate toxin production;
– to neutralize any toxin that is formed. If the toxin
has already affected the patient

12. Treatment
• Antibiotics (for example, metronidazole[Flagyl, Flagyl
375, Flagyl ER], penicillin G
or doxycycline [Adoxa, Alodox, Avidoxy, Doryx, Monod
ox, Oracea, Oraxyl, Periostat, Vibramycin, Vibramycin
Calcium, Vibramycin Monohydrate, Vibra-Tabs]) to kill
the bacteria, tetanus booster shot, if necessary, and
occasionally, antitoxin (termed tetanus immune
globulin or TIG) to neutralize the toxin

13. Treatment
• Wound cleansing to remove any obvious bacteria
collections (abscesses) or foreign bodies; if the patient
is exhibiting any toxin-related problems, TIG (tetanus
immune globulin) is usually administered first and
wound care is delayed for a few hours while the TIG
neutralizes toxin because infected wounds, when
manipulated, may release more toxin.

14. Treatment
• Supportive measures
• Pain medicine as needed
• Sedatives such as diazepam (Valium) to control
muscle spasms and muscle relaxants
• Ventilator support to help with breathing in the event of
spasms of the vocal cords or the respiratory muscles
• IV rehydration because, as muscles spasm
constantly, increased metabolic demands are placed
on the body

15. References
• http://kardzmed.com/kardz/2011-12-28-17-50-44/medicine-and-surgery/item/270-tetanus
• http://familymedicinehelp.com/introduction-to-tetanus
• http://bryanking.net/tetanus/
• http://health.nytimes.com/health/guides/disease/tetanus/overview.html
• http://www.emedicinehealth.com/tetanus/article_em.htm
• http://www.google.com.ph/imgres?q=tetanus&um=1&hl=tl&sa=N&biw=1280&bih=656&tbm=isch&tbnid=sf6JUMisTJe9lM:&imgrefurl=http://malct32.blogspot.com
/2010/06/tetanus.html&docid=4wxFVNqYEhBv0M&imgurl=http://4.bp.blogspot.com/_Qe1wgxDiEdU/TCtSIYmttLI/AAAAAAAAA2s/RybWObt_qTA/s1600/tetanus%25
2Binjection.jpg&w=450&h=270&ei=rK9ET7qGKIWviQexpomAAw&zoom=1
• http://www.google.com.ph/imgres?q=tetanus&um=1&hl=tl&sa=N&biw=1280&bih=656&tbm=isch&tbnid=FGOo2HMwTMGCSM:&imgrefurl=http://guggiedaly.blogs
pot.com/2010/05/one-thing-that-has-frequently-come-up.html&docid=6CVUsu7tYSwyVM&imgurl=http://4.bp.blogspot.com/-
NARRGfFFzg0/TsXF6BKKLJI/AAAAAAAAAuM/8WDXolqR35A/s1600/Pathophysiology-Of-
Tetanus.jpg&w=347&h=346&ei=rK9ET7qGKIWviQexpomAAw&zoom=1&iact=rc&dur=369&sig=112272707634528079433&page=1&tbnh=147&tbnw=153&start=0&n
dsp=17&ved=0CHQQrQMwDQ&tx=26&ty=46
• http://www.google.com.ph/imgres?q=tetanus&um=1&hl=tl&sa=N&biw=1280&bih=656&tbm=isch&tbnid=OY1tvaZ4M4XAzM:&imgrefurl=http://www.medicalook.co
m/Bacterial_infections/Tetanus.html&docid=27Zqp6BsdDZkSM&imgurl=http://www.medicalook.com/diseases_images/tetanus.gif&w=384&h=257&ei=rK9ET7qGKI
WviQexpomAAw&zoom=1&iact=rc&dur=428&sig=112272707634528079433&page=1&tbnh=137&tbnw=204&start=0&ndsp=17&ved=0CHwQrQMwDw&tx=50&ty=30
• http://www.google.com.ph/imgres?q=tetanus&um=1&hl=tl&sa=N&biw=1280&bih=656&tbm=isch&tbnid=claRfOYqaERsRM:&imgrefurl=http://www.healthyandstro
ng.net/tag/tetanus&docid=827hn8ccMLHkXM&imgurl=http://www.healthyandstrong.net/wp-content/uploads/2009/09/tetanus-
symptoms.jpg&w=333&h=227&ei=rK9ET7qGKIWviQexpomAAw&zoom=1&iact=rc&dur=267&sig=112272707634528079433&page=1&tbnh=147&tbnw=196&start=0&
ndsp=17&ved=0CGMQrQMwCQ&tx=66&ty=85
• http://www.google.com.ph/imgres?q=tetanus&um=1&hl=tl&sa=N&biw=1280&bih=656&tbm=isch&tbnid=do_cftCzlrPt8M:&imgrefurl=http://diseases-
blog.blogspot.com/2011/06/tetanus.html&docid=IiZw_YAxJo31ZM&imgurl=http://4.bp.blogspot.com/-
umco405fqqM/Te76TPIHFVI/AAAAAAAAAJE/oITaeGSYXuI/s320/tetanus.jpg&w=300&h=300&ei=rK9ET7qGKIWviQexpomAAw&zoom=1
• http://www.google.com.ph/imgres?q=tetanus+cause&um=1&hl=tl&noj=1&tbm=isch&tbnid=c-
WVdR60PjPHFM:&imgrefurl=http://www.albertahealthservices.ca/apple/4568.asp&docid=VBt32sXZL83I1M&imgurl=http://www.albertahealthservices.ca/apple/Ima
ges/app-tetanus.jpg&w=522&h=328&ei=C9ZET_fZBqGsiAeih5mJAw&zoom=1&biw=1280&bih=656
• http://www.google.com.ph/imgres?q=dog+bite+tetanus&um=1&hl=tl&noj=1&tbm=isch&tbnid=Tf8dYHT6PI0Z6M:&imgrefurl=http://www.sciencephoto.com/media/
265070/enlarge&docid=_mkQZc16qc2LuM&imgurl=http://www.sciencephoto.com/image/265070/large/M3301437-Dog_bite-
SPL.jpg&w=530&h=352&ei=WtZET9CsHee3iQf8oJyFAw&zoom=1&biw=1280&bih=656