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The bacteria generally enter through a break in the skin, such as a cut or puncture wound caused by a contaminated object. [1] [3] They produce toxins that interfere with normal muscle contractions. [4] Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people. [1]
Anti-tetanus immunoglobulin, also known as tetanus immune globulin (TIG) and tetanus antitoxin, is a medication made up of antibodies against the tetanus toxin. [1] It is used to prevent tetanus in those who have a wound that is at high risk, have not been fully vaccinated with tetanus toxoid , or have HIV/AIDS .
In such cases, it can be given with or without tetanus immunoglobulin (also called tetanus antibodies or tetanus antitoxin [10]). It can be given as intravenous therapy or by intramuscular injection. [citation needed] The guidelines for such events in the United States for non-pregnant people 11 years and older are as follows: [11]
The function of tetanolysin is unclear, although it may help C. tetani to establish infection within a wound. [6] [1] Tetanospasmin ("tetanus toxin") is a potent toxin with an estimated lethal dose less than 2.5 nanograms per kilogram of body weight, and is responsible for the symptoms of tetanus.
Tetanus prophylaxis is routinely given to enhance immune response against Clostridium tetani. Anti-tetanus immunoglobulin is only indicated for those with highly contaminated wounds with uncertain vaccination history. Single intramuscular dose of 3000 to 5000 units of tetanus immunoglobulin is given to provide immediate immunity. [5]
Surgical wounds can become infected by bacteria, regardless if the bacteria is already present on the patient's skin or if the bacteria is spread to the patient due to contact with infected individuals. [5] Wound infections can be superficial (skin only), deep (muscle and tissue), or spread to the organ or space where the surgery occurred. [5]
Neonatal tetanus (trismus nascentium) is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from an immunized mother are at risk. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument.
Tetanus toxoid should be administered based on local guidelines. [10] Using tissue plasminogen activator (tPA) within 24 hours of injury can both reduce tissue damage and increase amount of salvageable tissue by breaking up blood clots. [11] This has led to a corresponding reduction of amputations in previous trials. [11]