Tetanus is a serious bacterial infection that affects the nervous system, often causing painful muscle contractions, especially in the neck, jaw and in this case we speak of "tetanus trismus" (contracture of the jaw muscles). The bacterium that produces the toxin is Clostridium tetani, which is found in animal feces and soil; the infection can then develop from a puncture wound on the legs or arms. The disease can interfere with the ability to breathe and, if left untreated, can be fatal. There is a preventive vaccine that does not however represent a cure; if you have an infection, you must be hospitalized. Treatment focuses on managing and eliminating symptoms until the effects of the toxin wear off.
Steps
Part 1 of 2: Getting Medical Treatment
Step 1. Go to the hospital
In addition to stiffness and spasms in the neck and jaw muscles, tetanus also causes abdominal and spine cramps / stiffness, widespread muscle cramps, difficulty swallowing, fever, sweating, and rapid heartbeat. If you have symptoms of infection, you need to seek treatment at a clinic, as it is a serious illness that you cannot manage at home.
- Symptoms can develop at any time, from a few days to several weeks after contamination with the bacterium - often through a toe wound on a foot, for example by walking on a dirty nail.
- To diagnose the disorder, doctors perform a physical exam and collect a complete medical history that also includes vaccination status; there are no laboratory tests or blood draws to help identify tetanus.
- Among the diseases that have symptoms similar to this infection and that the doctor must rule out are: meningitis, rabies and strychnine poisoning.
- The medical staff cleans the wound, eliminates residues of dirt and / or earth, dead tissue and any foreign bodies.
Step 2. Get an injection of tetanus immunoglobulin
Depending on the time elapsed between the injury and the manifestation of symptoms, the doctor may opt for this solution, to cancel the effect of the toxins. Remember that this is not a cure and that it can only neutralize "free" toxins that have not yet bound to nerve tissues; those that have already affected the nerves do not suffer any damage.
- For this reason, it is extremely important to intervene promptly; the sooner you go to the doctor (once the symptoms are presented), the more effective the preventive action of immunoglobulins against the most severe symptoms.
- As soon as you are diagnosed with tetanus, you should be given a dose of between 3000 and 6000 units intramuscularly.
- Don't wait until you feel bad. If you have suffered a deep injury (such as a puncture wound) with some sharp object that looks like dirt, dust, feces, or other debris, go to the doctor or emergency room as a preventative measure to undergo the necessary medications and 'injection.
Step 3. Be prepared to take antibiotics
This class of drugs kills bacteria, including C. tetani, but the problem with tetanus is the toxins released by the spores. Once in the body, these substances have considerable strength, cause a wide variety of symptoms because they attack and stimulate the nervous tissue, a phenomenon that explains the spasms and widespread muscle contractions.
- If you can stop tetanus early, antibiotics are effective because they are able to kill bacteria before they release too much toxins.
- If the disease is in an advanced state, antibiotics may be relatively useless and the potential benefits may not outweigh the possible side effects.
- You may be given intravenous antibiotics. The best treatment for this infection is metronidazole in 500 mg doses given every 6-8 hours; this treatment must last at least seven or ten days.
Step 4. Expect to take sedatives or muscle relaxants
The most obvious and potentially fatal symptom associated with tetanus is severe contractions, defined by doctors as "tetany" (spasmophilia). If these spasms affect the muscles used to breathe, they can become fatal; therefore, taking muscle relaxants (such as metaxalone or cyclobenzaprine) can be life-saving, as well as relieving pain resulting from contractions.
- These drugs do not act directly on bacteria or toxins, but they can reduce the effect that excited nerves have on muscle fiber spasms.
- Tetany can be so violent that it can cause muscle tears and avulsed fractures - when strained tendons tear away bits of bone.
- Sedatives, such as diazepam (Valium), also help relieve muscle spasms, as well as reduce the anxiety and heartbeat associated with moderate or severe cases of tetanus.
Step 5. Prepare for supportive care
If your condition is severe, you need assistance with a respirator or mechanical ventilation. While the bacterium's toxins haven't affected your respiratory muscles excessively, you may need a lung of steel if you're under the influence of heavy sedatives, as they often trigger shallow breathing.
In addition to airway obstruction and respiratory arrest (which are the main causes of death from tetanus), other potential complications can arise, such as: pneumonia, heart failure, brain damage and bone fractures (the most common are ribs and to the spine)
Step 6. Ask your doctor about other possible medications that are helpful for your situation
There are some medicines that are sometimes used to soothe the symptoms of infection, such as magnesium sulfate (which manages muscle spasms), some beta blockers (which regulate heart rate and breathing) and morphine (a strong sedative and pain reliever.).
Part 2 of 2: Reduce the Risk of Tetanus
Step 1. Vaccinate
This is the way to avoid tetanus. In Italy, tetanus is mandatory for all newborns, with the administration of a series of boosters of the DTaP vaccine, which contains antibodies capable of protecting against diphtheria, tetanus and pertussis. However, full protection against tetanus lasts only 10 years, so boosters are needed as a teenager and in adulthood.
- Usually, boosters are recommended every 10 years, starting from the age of 19.
- People who contract tetanus typically need to undergo the vaccine as part of treatment, as the infection does not provide future immunity.
Step 2. Treat the wound promptly
It is important to clean and disinfect any deep injury, especially if it is caused by a stinging object that has injured a foot, to kill the C. tetani bacterium and prevent it from releasing toxins into the body. Once the bleeding has stopped, rinse the cut thoroughly with clean water or a saline solution if you have it. afterwards, clean it with an alcohol-based antibacterial sanitizer before covering it with a clean patch.
- You can also apply a topical antibiotic, such as Neosporin, which helps stop the infection. it does not promote faster healing, but slows bacterial growth.
- Change the patch / bandage regularly at least once a day or when it is wet or dirty.
Step 3. Wear appropriate footwear
Most cases of tetanus can be traced back to a foot injury caused by a sharp object - nails, glass, splinters - covered in animal feces or soil contaminated with C. tetani spores. Therefore, it is a good practice of prudence and prevention to wear sturdy shoes with resistant soles, especially if you are in rural environments and farms.
- Always keep sandals or flip flops when walking on the beach or shoreline.
- Don't forget to also protect your hands when working outdoors or in the workshop; wear thick gloves made of leather or some equally strong material.
Advice
- Tetanus is a rare infection in Western countries, while it is much more frequent in underdeveloped ones; about one million people get sick every year.
- Although they are dangerous for a short period of time, tetanus toxins do not cause permanent damage to the nervous system once symptoms subside.
- Remember that it is not a contagious infection and you cannot get sick by coming into contact with an infected person.
Warnings
- Without vaccine or without any kind of drug treatment, about 25% of sick people die, especially those with weak immune systems (infants, the elderly and those with chronic diseases).
- If you have any signs or symptoms of tetanus, do not try to treat yourself at home; it is a serious infection that requires medical treatment in the hospital.
