Agent: BACTERIUM.
Clostridium tetani
An anaerobic gram-positive bacillus

Reservoir: Animal feces  Soil

Vector: None

Vehicle: Injury

Incubation Period: 6d - 8d (range 1d - 90d)

Diagnostic Tests: Isolation of C. tetani from wound is rarely helpful.
Serology (specimen taken before administration of antitoxin).

Typical Adult Therapy
Human antitoxin (see Vaccine module).
Metronidazole (2 g daily) or Penicillin G (24 million u daily) or Doxycycline (200 mg daily).
Diazepam (30 to 240 mg daily).
Tracheostomy, hyperalimentation

Typical Pediatric Therapy
Human antitoxin (see Vaccine module).
Metronidazole (30 mg/kg daily); or Penicillin G (300,000 units/kilo daily).
Diazepam.
Tracheostomy, hyperalimentation

Vaccines:
DT vaccine
DTaP vaccine
DTP vaccine
Td vaccine
Tetanus immune globulin
Tetanus vaccine

Clinical Hints
Trismus, facial spasm, opisthotonus, tachycardia and recurrent tonic spasms of skeletal muscle; sensorium is clear; disease may persist for 4 to 6 weeks; case fatality rate = 10% to 40%.

Synonyms: (7 listed)
Lockjaw
Starrkrampf
Stelkramp
Tetano
Tetanos
ICD9: 037,771.3
ICD10: A33,A34,A35