Clinical Manifestations The initial symptom is cramping and twitching of muscles around a wound. The patient usually has no fever but sweats profusely and begins to experience pain especially in the area of the wound and around the neck and jaw muscles(trismus). Portions of the body may become extremely rigid, and opisthotonos角弓反张( a spasm In which the head and heels are bent backward and the body bowed forward) is common Complications include fractures, bowel impaction, intramuscular hematoma, muscle ruptures, and pulmonary renal, and cardiac problems
Clinical Manifestations ◼ The initial symptom is cramping and twitching of muscles around a wound. The patient usually has no fever but sweats profusely and begins to experience pain, especially in the area of the wound and around the neck and jaw muscles (trismus). ◼ Portions of the body may become extremely rigid, and opisthotonos角弓反张(a spasm in which the head and heels are bent backward and the body bowed forward) is common. ◼ Complications include fractures, bowel impaction, intramuscular hematoma, muscle ruptures, and pulmonary, renal, and cardiac problems
Clinical Manifestations DISEASE CLINCAL MANIFESTATIONSA Generalized Involvement of bulbar and paraspinal muscles(trismus or lockjaw, risus sardonicus, difficulty swallowing, irritability, opisthotonos);involvement of autonomic nervous system(sweating, hyper thermia, cardiac arrhythmias, fluctuations in blood pressure) Cephalic Primary infection in head, particularly ear isolated or com bined involvement of cranial nerves, particularly seventh cranial nerve; very poor prognosIs Localized Involvement of muscles in area of primary injury; infection may precede generalized disease favorable prognosis Neonatal Generalized disease in neonates; infection typically originates from umbilica脐带 stump very poor prognosis in infants whose mothers are nonimmune
Clinical Manifestations DISEASE CLINCAL MANIFESTATIONSA Generalized Involvement of bulbar and paraspinal muscles(trismus or lockjaw, risus sardonicus, difficulty swallowing, irritability, opisthotonos);involvement of autonomic nervous system(sweating, hyper thermia, cardiac arrhythmias, fluctuations in blood pressure) Cephalic Primary infection in head,particularly ear;isolated or combined involvement of cranial nerves, particularly seventh cranial nerve; very poor prognosis Localized Involvement of muscles in area of primary injury; infection may precede generalized disease; favorable prognosis Neonatal Generalized disease in neonates; infection typically originates from umbilical脐带 stump;very poor prognosis in infants whose mothers are nonimmune
Tetanus. Tetanus
Epidemiology 1 million cases of tetanus occur annually in the world, with a mortality rate ranging from 20%o to 50%o. But rare in most developed countries. In some developing countries, tetanus is still one of the ten leading causes of death, and neonatal tetanus accounts for approximately one-half of the cases worldwide In less developed countries, approximate mortality rates remain 85%o for neonatal tetanus and 50%o for nonneonatal tetanus In the United States, intravenous drug abusers have become another population with an increasing incidence of clinical tetanus In untreated tetanus the fatality rate is 90%o for the newborn and 40%/o for adults
Epidemiology ◼ 1 million cases of tetanus occur annually in the world,with a mortality rate ranging from20% to 50%. But rare in most developed countries. ◼ In some developing countries, tetanus is still one of the ten leading causes of death, and neonatal tetanus accounts for approximately one-half of the cases worldwide. ◼ In less developed countries, approximate mortality rates remain 85% for neonatal tetanus and 50% for nonneonatal tetanus. ◼ In the United States, intravenous drug abusers have become another population with an increasing incidence of clinical tetanus ◼ In untreated tetanus, the fatality rate is 90% for the newborn and 40% for adults
ImmunIty Humoral immunity(antitoxin) There is little, if any, inate immunity and the disease does not produce immunity in the patient. Active immunity follows vaccination with tetanus toxoid
Immunity ◼ Humoral immunity(antitoxin) ◼ There is little, if any, inate immunity and the disease does not produce immunity in the patient. ◼ Active immunity follows vaccination with tetanus toxoid