PATHOPHYSIOLOGY

Precipitating Factors:
Work (Farming)
Exposure to bacteria
(laceration at left foot)
No previous history of
tetanus immunization
oxins pro!uce! by gro"ing
cells
#egetative
gro"th
Clostridium tetani bacteria
containing virulence
plasmi!s enter "oun!
$pores germinate un!er
anaerobic con!itions
Pre!isposing Factors:
%ge
&en!er ('ale)
$pore
outgro"th
etanolysin
(elease of
bacterial
en!otoxins into
surroun!ing
)ell lysis
occurs
Enter )entral Nervous
$ystem ()N$) along
peripheral nerves
oxin circulate!
aroun! the bo!y
through
bloo!stream an!
lymphatic system
(elease of biochemical
me!iators of in*ammatory
response (histamine+
bra!ykinin)
Potentiating of
infection
etanospasmin (potent
neurotoxin)
Metronidazole 500 mg tab
BID PO
Cefazolin mg ITT !"
Gentam#$in 50 mg ITT !"
Metronidazole 500 mg tab
BID PO
Cefazolin mg ITT !"
Gentam#$in 50 mg ITT !"
Tetan%& To'oid
STAT ( tab )ia *GT
Tetan%& To'oid
STAT ( tab )ia *GT
oxin makes its "ay to
spinal cor!
,n*ammatory response
initiate!
,rreversibly bin!s to
gangliosi!es at
presynaptic inhibitory
motor nerve en!ings
Fever
$timulation of
hypothalamus to
increase bo!y
temperature
Phagocytes release
en!ogenous pyrogens
$"elling
,ncrease! bloo!
*o"
,ncrease!
capillary
permeability
W-)s such as
neutrophils an!
monocytes
enter
Phagocytosis an!
removal of !ebris
occur
(e!ness
)rosses to synaptic
cleft
oxin taken up by
neuromuscular
.unction
oxin enters the
)N$
oxin not able to
pass through
bloo!/brain barrier
&lottis Pharynx
&eneralize! tonic muscle
spasms occur
Excitatory activities
unregulate!
-locks the release of
inhibitory
neurotransmitters
(glycine an! &%-%)
aken up by
preganglionic neuron
axon through
en!ocytosis
(espiratory
muscles
Lo$+,a-
'asseter
muscle
Facial
muscle
)ranial
muscle
(api! 0ring
of impulses
1iaphrag
m
)hest "all
muscle
&,
(laryn
x+
ab!o
minal
"all)
Pneumonia
.ail%re
to &/ea+
or $r#
o%t
%spiration
of oral
secretions
(isus
sar!onicu
s (0xe!
smile an!
elevate!
eyebro"s
)
,rritability
of neurons
Diaze/am (0 mg
ITT !(0
Diaze/am (0 mg
ITT !(0
Para$etamol
STAT ( am/ ITT
STAT 500 mg tab
PO
Para$etamol
STAT ( am/ ITT
STAT 500 mg tab
PO
Ba$lofen (0 mg TID
PO
Ba$lofen (0 mg TID
PO
Mefenami$
a$id 500 mg
$a/ TID PO
Mefenami$
a$id 500 mg
$a/ TID PO
Carbamaze/in
e 000 mg tab
BID PO
Carbamaze/in
e 000 mg tab
BID PO
Pain
2E&EN1:
)linical manifestations
$igns an! symptoms
'e!ications
)hest "all
rigi!ity
%sphyxiation
3ypoxemia
D1ATH
)ar!iac %rrest
(espiratory
failure
Am/i$illin Sodi%m 2 S%lba$tam Sodi%m (35 g
ITT !" after A*ST 456
Peni$illin G Benzat7ine 500 89: !" ITT after
A*ST 456
Am/i$illin Sodi%m 2 S%lba$tam Sodi%m (35 g
ITT !" after A*ST 456
Peni$illin G Benzat7ine 500 89: !" ITT after
A*ST 456