Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.
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The management of generalized tetanus is a high-stakes, multidisciplinary endeavor that requires immediate and aggressive intervention. The therapeutic strategy is built on three pillars: neutralizing unbound toxin, eradicating the source of the toxin, and managing the symptoms until the nervous system regenerates. Because the toxin’s effects are long-lasting, treatment is supportive and palliative, aiming to keep the patient alive while the body heals over the course of weeks.
The priority is to stop the progression of the disease. Human Tetanus Immune Globulin (TIG) is administered immediately. This preparation contains high antibody titers against tetanus toxin.
To stop the production of new toxins, the bacterial factory must be shut down.
Managing the violent spasms is the most challenging aspect of care. The patient is often kept in a quiet, darkened room to minimize external stimuli that could trigger seizures.
Respiratory failure is the leading cause of death in tetanus. The spasms can close the throat (laryngospasm) or freeze the chest wall muscles.
The “autonomic storms” characterized by wildly fluctuating blood pressure and heart rate require specialized pharmacological management.
The metabolic demand of tetanus is immense. The constant muscle contractions burn calories at a rate comparable to running a marathon every day.
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No. The antitoxin (TIG) only neutralizes the toxin floating in the blood that hasn’t yet reached the nerves. It stops the disease from worsening, but it cannot remove the toxin already bound to the nerves. The existing symptoms will take weeks to resolve as the body regenerates the damaged nerve endings.
Patients with tetanus are susceptible to stimuli. A sudden bright light, a loud noise, or even a light touch on the arm can trigger a violent, painful full-body seizure. Keeping the environment dark and silent minimizes these triggers and helps prevent the spasms.
A tracheostomy is a surgical opening in the front of the neck into the windpipe. A breathing tube is placed there. In tetanus, the vocal cords can spasm shut, blocking breathing. A tracheostomy bypasses the vocal cords to ensure a safe airway. It is also safer for long-term ventilation than a tube down the throat.
The constant, intense muscle contractions of tetanus burn a tremendous amount of energy. A patient with tetanus may need twice the normal daily calories to maintain their weight. Without aggressive nutritional support, the body would break down its own muscle tissue for energy, leading to severe weakness and longer recovery.
Generally, yes. If the patient survives the acute phase of the illness, the recovery of nerve function is usually complete. The nerve terminals regenerate, and muscle control returns to normal. However, patients may have long-term stiffness, psychological trauma, or complications from the extended hospital stay (like muscle weakness) that require physical therapy.
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