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( Tetanus)
Tetanus is a medical condition that is characterized by a prolonged contraction of skeletal muscle fibres. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. Infection generally occurs through wound contamination, and often involves a cut or deep puncture wound. As the infection progresses, muscle spasms in the jaw develop, hence the common name, lockjaw. This is followed by difficulty in swallowing and general muscle stiffness and spasms in other parts of the body.[1] Infection can be prevented by proper immunization and by post-exposure prophylaxis.[2] Tetanus affects skeletal muscle, a type of striated muscle. The other type of striated muscle, cardiac or heart muscle cannot be tetanized, because of its intrinsic electrical properties. In recent years, approximately 11% of reported tetanus cases have been fatal. The highest mortality rates are in unvaccinated persons and persons over 60 years of age. C.&_160;tetani, the bacterium that causes tetanus, is recovered from the initial wound in only about 30% of cases, and can be found in patients who do not have tetanus.[2] The incubation period of tetanus ranges from 3 to 21 days, with an average onset of clinical presentation of symptoms in 8 days. In general, the further the injury site is from the central nervous system, the longer the incubation period. The shorter the incubation period, the higher the chance of death. In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 days. On the basis of clinical findings, four different forms of tetanus have been described.[2] The "spatula test" for tetanus involves touching the posterior pharyngeal wall with a sterile, soft-tipped instrument, and observing the effect. A positive test result is the involuntary contraction of the jaw (biting down on the "spatula"), and a negative test result would normally be a gag reflex attempting to expel the foreign object.
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