Tetanus natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Tetanus can have an incubation period of 2 to 38 days with the man being 7 to days post exposure. The presentation and progression may vary depending on the type tetanus. Generalized tetanus can involve the respiratory muscles making it difficult to breathe. The complications of tetanus include fractures, laryngospasm, aspiration pneumonia and pulmonary embolism.Tetanus has a fatality rate of almost 11%. The fatality rate of tetanus might be associated with prolonged convulsions and contractions.[1]
Natural History
Tetanus can have an incubation period of 2 to 38 days with the man being 7 to days post exposure. Patients with generalized type can have spasmodic contractions of the muscles associated with inability to breathe an thus apnea develops. This can lead to the death of the individual if not addressed immediately.[1][2]
Complications
There are many complications associated with tetanus infection. Some of the complications are as follows:[3]
- Laryngospasm
- This can be associated with spasms of the muscles of respiration which leads to breathing difficulties.
- Fractures of the spine or long bones
- This may result from prolonged contractions and convulsions
- Hyperactivity of autonomic nervous system
- This may lead to an abnormal heart rhythm and/or hypertension
- Nosocomial infections
- Common because of prolonged hospitalization
- There are commonly some secondary infections including:
- Sepsis from indwelling catheters
- Hospital-acquired pneumonia
- Decubitus ulcers
- Pulmonary embolism
- Apparent in drug users and the elderly
- Aspiration pneumonia
- Common late complication
- Found in 50%-70% of autopsied cases
Prognosis
Tetanus results in death in almost 10-20% of cases. The rate of death is higher among older people. The fatality rate of tetanus might be associated with prolonged contractions and convulsions.[1] In the recent years:
- Tetanus has been fatal in approximately 11% of reported cases
- Most commonly fatal cases found in:
- People of 60 years or older (approximately 18%)
- Unvaccinated people (approximately 22%)
- In about 20% of deaths, no obvious pathology is detected
- Death is attributed directly to the direct effects of tetanus toxin.
References
- ↑ 1.0 1.1 1.2 Thwaites CL, Beeching NJ, Newton CR (2015). "Maternal and neonatal tetanus". Lancet. 385 (9965): 362–70. doi:10.1016/S0140-6736(14)60236-1. PMID 25149223.
- ↑ "Tetanus | Symptoms and Complications | Lockjaw | CDC".
- ↑ J. J. Farrar, L. M. Yen, T. Cook, N. Fairweather, N. Binh, J. Parry & C. M. Parry (2000). "Tetanus". Journal of neurology, neurosurgery, and psychiatry. 69 (3): 292–301. PMID 10945801. Unknown parameter
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