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Infectious Disease Online

Pathology of Tetanus

Dr Sampurna Roy MD




Tetanus (lockjaw) results from the absorption of the potent exotoxin produced by Clostridium tetani.

This free-living saprophyte, widespread in nature, especially in cultivated soil, is commonly found in the faeces of cattle and horses and less commonly of humans.

It therefore tends to colonize manured areas of cultivation. Once introduced into an area, spores of Clostridium tetani persist almost indefinitely.

Tetanus is therefore particularly a hazard in intensively cultivated rural areas.

Tetanus results from the introduction of spores of Clostridium tetani into tissue, where anaerobic conditions favorable to germination and toxin production may be present.

Punctured wounds as from a nail or splinter are particularly dangerous.

Tetanus was once a frequent complication of abortion and was also commonly seen in infants as tetanus neonatorum , which resulted from the infection of the umbilical stump.

Active immunization has contributed to a decline in the occurrence of tetanus. 

Tetanus toxin is absorbed from the local site of production and is transmitted into the central nervous system along the axons of neurons.

Tetanus toxin is a potent neurostimulatory agent.

Clinical features of tetanus may appear several weeks or even months after the responsible injury, and in a considerable number of cases no injury can be demonstrated or recalled.

Symptoms begin with headache, followed shortly by difficulty in swallowing and stiffness of the jaw.

Muscle stiffness or spasm may initially be confined to the region of the local infection (local tetanus).

Spasm of the muscles of the trunk may lead to opisthotonos.

Contraction of the facial muscles produces the characteristic risus sardonicus.

Consciousness is undistributed, and perception of pain is undiminished.

Death results from inanition or secondary complications such as bronchopneumonia.

Specific morphologic changes have not been described.

A reliable diagnostic procedure is the demonstration of muscle spasm in guinea pigs injected with wound scrapings suspended in a saline solution.

The presence of tetanus bacilli established by culture is not diagnostic, since spores of C. tetani frequently contaminate wounds.

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Further  reading:

Rabies, tetanus, leprosy, and malaria.

Vaccine model of antiphospholipid syndrome induced by tetanus vaccine.

Induction of decreased fecundity by tetanus toxoid hyper-immunization in C57BL/6 mice depends on the applied adjuvant.

A lethal case of generalized tetanus.

[Tetanus as a complication of leg ulcer associated with necrotic purpura].

Tetanus toxoid reactive lymphadenopathy masquerading as T-cell lymphoma.

[A case of tetanus originating from ulcerated breast cancer].

The ocular conjunctiva as a mucosal immunization route: a profile of the immune response to the model antigen tetanus toxoid.

One or two doses of quadrivalent meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine is immunogenic in 9- to 12-month-old children.

One or two doses of quadrivalent meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine is immunogenic in 9- to 12-month-old children.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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