The tetanus toxin, one of the most potent poisons known, acts on the motor nerves and causes muscle spasm at the site of infection and in other areas of the body. The most frequent symptom is stiffness of the jaw (lockjaw) and facial muscles. Difficulty in breathing and severe convulsions may ensue. The mortality rate is very high, especially in the very young and the aged; overall it is about 40%. Treatment with tetanus antitoxin should be started promptly in conjunction with human immune globulin. It is preferable, however, to prevent the disease by active immunization (including booster shots) with tetanus toxoid (see vaccination).
Acute bacterial disease caused by Clostridium tetani (see clostridium). Spores of this organism are common, especially in soil; it thrives away from oxygen in deep wounds, especially punctures. Its toxin stimulates nerves, causing muscle rigidity with frequent spasms. This may occur around the site of the wound or, if the toxin reaches spinal motor ganglia via the bloodstream, throughout the body. The jaw muscles are almost always involved (lockjaw). Vaccination every few years is the best protection; an antitoxin prevents or delays symptoms in cases of suspect wounds but has limited value once they develop. Treatment usually includes antibiotics, sedatives, and muscle relaxants. Recovered patients are not immune.
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