Diagnosis Diagnosis is primarily by the clinical symptoms (above). The wound may not be obvious C tetani can be recovered from the wound in only about one-third of the cases It is important for the clinician to be aware that toxigenic strains of C tetani can grow actively in the wound of an immunized person. Numerous syndromes, including rabies and meningitis, have symptoms similar to those of tetanus and must be considered in the differential diagnosis
Diagnosis ◼ Diagnosis is primarily by the clinical symptoms (above). The wound may not be obvious. ◼ C tetani can be recovered from the wound in only about one-third of the cases. ◼ It is important for the clinician to be aware that toxigenic strains of C tetani can grow actively in the wound of an immunized person. ◼ Numerous syndromes, including rabies and meningitis, have symptoms similar to those of tetanus and must be considered in the differential diagnosis
Vaccination infant DPT(diptheria, pertussis, tetanus) tetanus toxoid antigenic no exotoxic activity
• infant • DPT (diptheria, pertussis, tetanus) • tetanus toxoid – antigenic – no exotoxic activity Vaccination
Control The offending organism must be removed by local debridement清创 术 toxoid i Metronidazole( For more serious wounds) AIDS patients may not respond to prophylactic injections of tetanus toxoid
Control ◼ The offending organism must be removed by local debridemen清创 术 ◼ toxoid ◼ TAT; Metronidazole (For more serious wounds) ◼ AIDS patients may not respond to prophylactic injections of tetanus toxoid
C perfringens soil fecal contamination ° gas gangrene swelling of tissues -gas release s fermentation products wound contamination
C. perfringens • soil, fecal contamination • gas gangrene – swelling of tissues – gas release * fermentation products • wound contamination
Toxins toxin Biological Types of Toxins Feature A E lecithinase: increase the C vascular permeability; |+++|十 hemolytic; produces necrotizing activity Necrotizing activity, induces hypertension by causing release of catecholamines 8 increase the permeability of gastrointestinal wall Necrotizing activity; increase the vascular permeability
Toxins toxin Biological Feature Types of Toxins A B C D E lecithinase; increase the vascular permeability; hemolytic; produces necrotizing activity + + + + + Necrotizing activity, induces hypertension by causing release of catecholamines. － + + － － increase the permeability of gastrointestinal wall － － － + － Necrotizing activity; increase the vascular permeability － － － － +