PATHOPHYSIOLOGY OF TETANUS

Precipitating Factors: Predisposing Factors:

 Exposure to bacteria  Age

(laceration at left foot)  Gender (Male)
 Unknown history oftetanus
imunization

Clostridium tetani bacteria containing virulence

plasmids enter wound

Toxins produced by growing cells

Spores germinate under anaerobic

conditions (3-21 days incubation)

Cell lysis occurs

Fever
Release of bacterial endotoxins into surrounding tissues

Inflammatory Stimulation of
Tetanospasmin
response hypothalamus

Toxin circulated around the body through bloodstream and lymphatic system

Autonomic
Enter Central Nervous System (CNS) along peripheral nerves
Dysfunction

Toxin makes its way to spinal cord Tachycardia

Toxin taken up by neuromuscular junction

Irreversibly binds to gangliosides at presynaptic inhibitory motor nerve endings

Taken up by preganglionic neuron axon through endocytosis

Blocks the release of inhibitory neurotransmitters (glycine and GABA)

Excitatory activities unregulated

Generalized tonic muscle spasms occur

 Generalized tonic muscle spasms occur

Pharynx Masseter muscle Respiratory

muscles

Aspiration of oral Lock Jaw

secretions Dyspnea Chest wall rigidity

Cough Retractions Asphyxiation

DEATH Respiratory failure