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Tetanus (Clinical Signs and Symptoms (Trismus: intense spasms of the…
Tetanus
Etiology
Caused by wound exposure to a toxin produced by Clostridium retain, an anaerobic bacterium found in the soil
Pathophysiology
Tetanus toxin blocks the inhibitory motor and autonomic neurons in the spinal cord, resulting in the intense muscle spasms/rigidity as well as sympathetic overactivity
The toxin does not affect sensory neurons, so patients remain fully away and typically experience severe pain associated with the muscle spasms
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Differential Diagnosis
Presence of serum antitoxin levels greater than 0.01 U/mL can help rule out a diagnosis of tetanus :red_flag:
Trismus: intense spasms of the master muscle, commonly called "Lockjaw" :red_flag:
Recommend toxicology screen for drug-induced dystopias or strychnine poisoning and a neurology assessment for other causes of seizures :red_flag:
Respiratory Management
If ventilation or upper airway function are compromised, recommend intubation, mechanical ventilation and transfers to ICU
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Diagnostic testing
Recent history
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Necrotic or anaerobic infection (infected umbilical stumps, septic abortions, aerobic periodontal infections, chronic diabetic ulcers
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Presence of serum antitoxin levels greater than 0.01 U/mL can help rule out a diagnosis of tetanus :red_flag:
Recommend toxicology screen for drug-induced dystopias or strychnine poisoning and a neurology assessment for other causes of seizures :red_flag: