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Pathology: Clostridium tetani

Clostridium tetani is a gram positive anaerobic spore-forming rod that produces a potent exotoxin. The toxin on acting on the synapse of motor nerves and blocking inhibitory neurons, leads to tetanic spasm. Incubation time of the bacteria is 5-10 days. Clostridium tetani is rarely seen in locations with proper vaccination and hygienic living conditions.


Infection of Clostridium tetani occurs through inoculation of spore or organism into a wound or trauma, causing a break in the skin.


A 24 hour period of restlessness, malaise and uneasiness precedes the occurrence of the disease.


Hypertonicity occurs in the form of trismus and neck muscle spasms. Thereafter, truncal muscles also start to spasm. This condition lasts for 2-3 months. Reflex spasms, which are violent, sustained muscle contractions, in which the patient remains conscious, occur and last for 7-21 days.


Clinical diagnosis is the only investigation used to diagnose Clostridium tetani.


  • Medical: Intravenous benzylpenicillin, sedation, paralysis with tracheostomy and ventilation.
  • Surgical: Wound debridement
  • Antitoxin: Human tetanus immunoglobulin


Aspiration pneumonia, exhaustion and death are the possible complications of this disease.


The mortality rate of Clostridium tetani ranges from 25-50%, depending on the incubation period and time taken for the onset of the first spasm. A shorter incubation period and onset of first spasm within 24 hours worsen the chances of recovery.

Figure 9.2 Opisthotonus

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