Classification of tetanus
There are four different forms of tetanus:
- localised
- rare and relatively milder form of disease
- spasm and rigidity are restricted to the site of injury
- in some, may precede generalised tetanus
- cephalic
- occurs secondary to a middle ear infection or from a injury to the head and neck
- cranial nerve palsies (especially the seventh nerve) is characteristic
- may develop in to a generalised disease
- prognosis is poor (1)
- generalized
- most common type and is responsible for around 80% of patients
- there is haematogenous spread of the toxin
- head and neck muscles are affected first with progressive distal spread of spasm and rigidity throughout the body
- neonatal
- is responsible for over 50% of deaths associated with tetanus
- caused by poor umbilical hygiene and is entirely preventable by maternal vaccination
- symptoms like failure to thrive, poor sucking, grimacing and irritability is seen at first quickly followed by intense rigidity and spasms and is usually seen from 4 to 14 days after birth (average around 7 days) (2)
- is completely eliminated from the UK (1)
References:
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