Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 3 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Tetanus
Consultant Anaesthetist, Department of Anaesthesia, Nottingham University Hospitals, NHS Trust Nottingham NG7 2UH, UK Tel: 0115 9249924 Fax: 0115 970 0739 E-mail: andytanaes@hotmail.com
| The first 150 words of the full text of this article appear below. |
| Key points Tetanus is a preventable disease; it is a significant cause of mortality worldwide causing one million deaths annually. At least 20 cases of tetanus occur in the UK each year. Management of tetanus is essentially supportive using antibiotics, surgery, immunization, sedation and, when necessary, ventilation. The mortality from tetanus remains high despite modern intensive care.
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Tetanus is caused by a neurotoxin released by Clostridium tetani, a spore-forming anaerobic bacterium. It occurs throughout the world and remains an important cause of death with an estimated annual mortality of 800 000–1 000 000. Over half of these deaths are in neonates. Tetanus is relatively rare in the developed world. For example, there are 5–10 cases per year in the UK; 75% of these occur in individuals over the age of 45 yr. There have been no cases in the UK of tetanus in the newborn for over 30 yr.
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Epidemiology |
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Pathophysiology |
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Mortality |
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Clinical features |
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Classification of tetanus
Grading severity
Differential diagnosis
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Management |
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Neutralization of unbound toxin
Surgical debridement
Control of muscle rigidity and spasms
Control of autonomic instability
Supportive treatment