Tetanus

 

NEET PG High-Yield: Tetanus

A severe neurological disorder caused by the neurotoxin (tetanospasmin) produced by Clostridium tetani. It is non-communicable and preventable via immunization.

Feature Details
Causative Agent Clostridium tetani (Gram-positive, anaerobic, spore-forming bacillus).
Mechanism Tetanospasmin blocks the release of inhibitory neurotransmitters (GABA and Glycine).
Incubation Period 3–21 days (usually < 14 days; shorter incubation = worse prognosis).

Clinical Presentation

  • Trismus: Lockjaw (usually the first sign).
  • Risus Sardonicus: Characteristic facial expression.
  • Opisthotonos: Arching of the back due to muscle spasms.
  • Neonatal Tetanus: Typically occurs through infection of the umbilical stump (improper cord care).
High-Yield NEET PG Pearls:

  • Prevention: Tetanus Toxoid (TT) vaccination is the cornerstone. Maternal immunization prevents neonatal tetanus.
  • Post-Exposure Prophylaxis: Depends on wound severity and patient’s vaccination history (use both Tetanus Immunoglobulin [TIG] and TT for high-risk wounds).
  • Treatment: Control spasms (Benzodiazepines), neutralize unbound toxin (TIG), and eradicate the source (Metronidazole).
  • Spatula Test: A highly sensitive diagnostic test where stimulating the posterior pharyngeal wall causes a reflex jaw contraction (trismus).