How Tetanus Occurred By Clostridium Tetani

আজকে আমাদের পড়াশুনার টপিক – Clostridium tetani. Clostridium tetani causes tetanus.

👉প্রথমেই জেনে নিই Morphology:
📌 1. Anaerobic, spore forming, gram positive.
2. Rod shaped with rounded ends.
3. Produce a spherical,terminal spore which is larger than the bacillary body.(এর জন্যই gram staining এ “tennis racket” appearance দেখা যায়)
4. Non-capsulated, motile with peritrichous flagella(slow and steady movement), non-acid fast.

👉Tetenus এর types কি কি আছে?
♦ 1. Otogenic tetanus.
2. Tetanus neonatorum.
3. Post-operative tetanus.
4. Cryptogenic tetanus.

👉Transmission কিভাবে হয়❓
💠 এই bacteria এর spore mainly soil এ থাকে [ specially barnyard and garden soil], portal of entry হচ্ছে wound site. Spore can also be introduced during “skin-popping”. Neonatal tetanus এর ক্ষেত্রে contaminated umbilicus or circumcision wound এর মাধ্যমে ছড়ায়।

👉 Clinical findings / features কি কি হবে❓
🚩 Tetanus is characterized by strong muscle spasms ( spastic paralysis)

  1. Lock jaw ( Trismus) : due to rigid contraction of the jaw muscles.( ফলে মুখ খোলা যায় না/ বড় করে হা করা যায় না)
  2. Risus sardonicus : A characteristic grimace.
  3. Opisthotonos : A pronounced arching of the back due to spasm of the strong extensor muscles of the back.(মানে হচ্ছে শরীর ধনুকের মত বেঁকে যায়)

👉 Clostridium tetani কি কি toxins produce করে?
⭕ 1. Tetanoplasmin (potent neurotoxin)
2. Tetanolysin.

👉Pathogenesis of tetanus:
💠 Spores of Cl.tetani are widespread in the soil.

এই spore যেকোন wound site ( like deep penetrated/lacerated wound, burn, umbilical stump, surgical suture) দিয়ে body তে ঢুকবে।

Traumatized tissue তে organism টা germimate করে এবং turn into vegetative form.

Multiplication হবে এবং toxin (tetanospasmin and tetanolysin) liberate করে। এই liberated toxin টা absorbed হয় motor nerve ending এ।

এই neurotoxin peripheral motor nerve দিয়ে anterior horn cell of the spinal cord এ যায় ( যাকে বলে retrograde transmission). তারপর tetanospasmin ganglioside receptor এর সাথে bind করে এবং inhibitory neurotransmitters release কে block করে দেয়।

Prevents inhibition of lower motor neuron by upper motor neuron..and exaggerated action of lower motor neuron on the muscles –

  1. increased muscle tone.
  2. Exaggerated muscular response.
  3. Hyper-excitability of voluntary muscles.
  4. Involuntary contraction( spastic contraction)

👉Laboratory diagnosis of tetanus কি হবে?
1. Specimen collection : Wound swab.
2. Microscopic examination : Gram staining – gram positive bacilli (tennis racket appearnce)

3. Culture :

🚩Robertson’s cooked meat media.
Finding – turbidity of medium and blackening of meat.
🚩Blood agar (finding- swarming growth)

👉 Prevention কি হবে?
⭕ Vaccine 😊
pre-exposure :
1st dose – at 6 weeks of age.
2nd dose – after 4-6 weeks.
3rd dose – after 4-6 weeks.
Booster dose – (4-6) years of age.
Additional – every 10 years after last dose.

Post -exposure prophylaxis:

  1. Tetanus immunoglobulin. (TIG)- 250 units in intravenous route.( gives immediate protection by passive immunization.)
  2. Tetanus Toxoid – intramuscular ( Gives long term protection by active immunization).

👉Treatment of tetanus:
⭕১. Treatment বলতে প্রথমেই মাথায় আসে TIG। মানে হচ্ছে TIG দিতে হবে patient কে।
২. Antibiotic এর মধ্যে Penicillin G or Metronidazole দিব।
৩. Anticonvulsant therapy : Diazepam(IV) দিতে পারি symptoms কে minimize করতে।
৪. Respiratory support, If needed.

🔴 Reference : Lange review of medical microbiology and immunology, 15th edition, page :134.
Lippincott’s Illustrated reviews, 3rd edition. Page : 156-157🔴

Platform Academic/ Tamanna Sultana

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