Hoalian

1. Local Tetanus. This is a persistent contraction of the muscles in the same areas as the infected wound. This form is generally mild, but also uncommon.
2. Cephalic Tetanus. This is a rare form which involves cranial nerves especially in the facial area affecting expressions, breathing and swallowing. It can affect adults with head injuries or children with ear infections as the bacteria enter through the ear.
3. Generalised Tetanus. This is the most common form accounting for about 80% of cases. The first sign is lockjaw (trismus) and facial spasms (risus sadonicus) followed by a stiff neck, difficulty in swallowing and rigidity in the pectoral and calf muscles. Spasms occur frequently and last several minutes shaping the body into a characteristic posture of an arched and rigid back called opisthotonos. The spasms last for 3-4 weeks and it can take months for a complete recovery.
4. Neonatal Tetanus. This is generalised tetanus that occurs in newborn babies. They are infected because they haven’t obtained passive immunity from their mother because she wasn’t immunised. It occurs through the infection of the unhealed umbilical stump, especially if it is cut by unsterilised equipment. Also in some countries it is traditional to put manure on the umbilical stump which can lead to infection. In developing countries this form is responsible for 14% of neonatal deaths but it is rare in developed countries.

You can do blood tests for tetanus but it takes a number of weeks for the body’s antibodies to appear in the blood and since tetanus can act quite quickly waiting for blood test results takes too long; a diagnosis is often made on clinical basis. This can usually be diagnosed by the characteristic lockjaw and prolonged muscle contractions of skeletal muscle fibres. Also a spatula test can be done which involves touching the pharynx, which is at the back of the mouth, with a soft-tipped, sterile instrument and observing the results. If there is an involuntary contraction of the jaw, making the person bite down on the spatula then the test is positive and the person has tetanus. A negative result would be a normal gag reflex reaction as the person tries to repel the foreign object from their mouth.



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