All about Bacterial Infections Caused by Gram-Positive Clostridium tetani with diagnosis Treatment Signs and symptoms

Bacterial Infections clostridium tetani


  • Tetanus is a neurological disease caused by clostridium tetani characterized by increased muscle tone and spasms due to a powerful exotoxin tetano­spasmjnproduced by the bacteria.
  • C. tetani is a Gram positive anaerobic rod with a ter­minal spore resembling a tennis~racket.
TETANUS Causes Diagnosis Treatment with Signs and Symptoms

Clinical manifestations TETANUS:

  • There is increased muscle tone and generalized spasms.
  • It occurs 3 – 13days after an injury such as a punc­ture wound, laceration or abrasion. It is also associ­ated with burns, surgery, abortion, child birth, gan­grene.
  • There is increased tone in the masseter muscles (jaw muscles) resulting in tri.smus or lock-jaw.
  • Lock-jaw is the first feature of tetanus.
  • ~There is dysphagia, stiffness of neck, shoulder and back muscles.
  • The abdomen is rigid.
  • Hands and feet are spared but proximal limb muscles are involved.
  • There is risus sardonicus (sarcastic smile) due to sus­tained contraction of facial muscles.
  • There is opisthotonus (arched back). There may be cyanosis and respiratory distress.
  • Convulsions are provoked by any stimulation like noise, light etc.
  • Patient may have fever.
  • Deep tendon reflexes are exaggerated.
  • There may be tachycardia, hypertension, arrhythmias, laryngeal spasm, respiratory arrest and cardiac ar­rest.
  • Diagnosis is usually clinical.

Treatment OF TETANUS

  • General supportive measures. Respiratory support.
  • Airway is protected.
  • Wound is cleaned and debrided.
  • Penicillin 10 – 12 million units daily IV for 10 days.
  • Metronidazole 500 mg §…b.r:l¥.
  • Clindamycin, Erythromycin.
  • V Antitoxin-human tetanus immune globulin is given to neutralize circulating toxin in the wound. Dose is 3000 – 6000 units intra muscular in di­vided doses.
  • Equine tetanus antitoxin may be used instead of. human antitoxin.
  • Muscle spasms are controlled by Diazepam, Lorazepam, Propofol, Magnesium sulphate.
  • Respiratory care – Tracheostomy and Mechani­cal ventilation.
Prevention OF TETANUS :
  • Active immunization – consists of 3 doses of teta­nus toxoid – 1st and 2nd doses are given 1 -2 months apart, 3rd dose is given after 6 – 12 months. Booster dose is given every 10 years.
neurotoxins produced by Clostridium botulinum


  • Botulism is a paralytic disease caused by neurotoxins produced by Clostridium botulinum.
  • There is cranial nerve involvement and the disease progresses downwards to the extremities.
  • Botulism may be food-borne, or wound botulism, or intestinal botulism.
  • Botulism occurs worldwide.
  • Botulinum toxin can be dispersed in an aerosol or mixed with food. Therefore, it is used in biological warfare and terrorism.
Clostridium botulinum

Clinical features BOTULISM:

  • There may be a mild ill ess or a severe disease re­sulting in death ithin 24 ho!J.[s.
  • Incubation period is 1 – 2 days.
  • -There is symmetrical descending paralysis with res­piratory failure and death.
  • -There is cranial nerve involvement, diplopia, dysar­thria, dysphagia.
  • There is nausia vomiting ,abdominal pain, dizziness, depressed pupillar reflexes, and decreased, deepaondon reflexes.
  • Diagnosis is by demonstration of the organism or its toxin in vomitus, gastric fluid or stool.

Treatment  BOTULISM :

  • Patients should be monitored and managed for respiratory failure.
  • Equine anti-toxin is given as soon as the case is diagnosed.
GAS-GANGRENE disease is caused by Clostridium perfringens


  • This disease is caused by Clostridium perfringens. They cause food poisoning, enteritis necroticans (ne­crotizing enteritis), suppurative deep tissue infections, skin and soft tissue infections, gangrene (Clostrid ial myonecrosis}.
  • reatment is cleaning and debriding the wound, Peni­cillin G 20 units/day or Clindamycin.


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