scholarly journals An unusual cause for neck rigidity?

2021 ◽  
Vol 7 (3) ◽  
pp. 161-163
Author(s):  
R H Gobbur ◽  
P Jagruthi ◽  
Anilkumar Sajjan ◽  
S S Kalyanshettar
Keyword(s):  
Clostridium Tetani ◽  
Inhibitory Neurotransmitters ◽  
Cephalic Tetanus

Otogenic tetanus is a subtype of cephalic tetanus, limited to the head & neck, but can progress to a more generalized form. Caused by the spore-forming bacillus, Clostridium tetani, It produces a potent toxin, tetanospasmin, preventing inhibitory neurotransmitters' release, hence causing rigidity.

scholarly journals Botulinum toxin A for trismus in cephalic tetanus

1994 ◽  
Vol 52 (3) ◽  
pp. 410-413 ◽  
Author(s):  
Luiz Augusto F. Andrade ◽  
Sonia Maria D. Brucki
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Pulmonary Complications ◽  
Toxin A ◽  
Clostridium Tetani ◽  
Considerable Difficulty ◽  
Respiratory Problems ◽  
Life Threatening ◽  
The Difference ◽  
Cephalic Tetanus

Cephalic tetanus is a localized form of tetanus. As in generalized forms , trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (Clostridium tetani and Clostridium botulinum, respectively), and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.

Cephalic tetanus presenting with bilateral facial palsy

2019 ◽  
Vol 64 (3) ◽  
pp. 108-111
Author(s):  
A Tahir ◽  
P Pokorny ◽  
N Malek
Keyword(s):  
Facial Palsy ◽  
The Body ◽  
Facial Weakness ◽  
Open Wound ◽  
Clostridium Tetani ◽  
The United Kingdom ◽  
Lower Jaw ◽  
Muscle Spasms ◽  
Cephalic Tetanus ◽  
Developing Muscle

We discuss the case and differential diagnoses of an elderly man who presented with bilateral facial palsy. He had injured his forehead in the garden during a fall on his face and the open wound was contaminated by soil. He then presented to the emergency department with facial weakness causing difficulty speaking. The penny dropped when he started developing muscle spasms affecting his lower jaw a day after admission. It also became clear that he could not open his mouth wide (lock jaw). The combination of muscle spasms and lock jaw (trismus) made tetanus the most likely possibility, and this was proven when he had samples taken from his wound and analysed under the microscope, which showed Clostridium tetani bacilli. C. tetani spores are widespread in the environment, including in the soil, and can survive hostile conditions for long periods of time. Transmission occurs when spores are introduced into the body, often through contaminated wounds. Tetanus in the United Kingdom is rare, but can prove fatal if there is a delay in recognition and treatment.

Ketamine in the management of generalised cephalic tetanus

2007 ◽  
Vol 122 (12) ◽  
pp. 1389-1391 ◽  
Author(s):  
O Obanor ◽  
H O Osazuwa ◽  
J E O Amadasun
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Airway Obstruction ◽  
High Mortality ◽  
Adjunctive Therapy ◽  
Anaesthetic Agent ◽  
Purulent Discharge ◽  
Clostridium Tetani ◽  
History Of ◽  
Cephalic Tetanus

AbstractBackground:Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus.Case report:A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury. She developed tetanic spasms 24 hours after admission. She had received no immunisations. A tracheostomy was established to relieve airway obstruction, and ketamine was added to the medication when breakthrough seizures were refractory to diazepam.Conclusion:Ketamine is of proven safety as an anaesthetic agent, especially in cases in which an anaesthetist is not readily available. Its effectiveness in this case, in combination with diazepam, warrants further evaluation.

scholarly journals Cephalic Tetanus without Injury – A Rare Presentation of Tetanus

2021 ◽  
Vol 10 (20) ◽  
pp. 1555-1557
Author(s):  
Ramanan B.B.V ◽  
Ajit Kumar Pegu ◽  
Anupam Dutta ◽  
Arjit Das ◽  
Sanchu T.K. Sreeraj
Keyword(s):  
Case Report ◽  
Clostridium Tetani ◽  
Rare Presentation ◽  
Puncture Wound ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Cephalic Tetanus

Tetanus is a rare, severe, and potentially life-threatening disease caused by Clostridium tetani, which accounted 58,900 deaths worldwide in 2013.1 Usually tetanus is generalized, rarely it can be localized also. 20-30% of cases will not have any puncture wound. In this case report, we present a case of tetanus with rare manifestation (localized tetanus presented with trismus without any puncture wound). Multiple rare associations like tetanus presenting with trismus, tetanus occurring in the absence of puncture wound strengthens the need for reporting this case which if left unnoticed would have been detrimental to the patient.

scholarly journals Novel Small Molecule Inhibitors That Prevent the Neuroparalysis of Tetanus Neurotoxin

2021 ◽  
Vol 14 (11) ◽  
pp. 1134
Author(s):  
Giulia Zanetti ◽  
Andrea Mattarei ◽  
Florigio Lista ◽  
Ornella Rossetto ◽  
Cesare Montecucco ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Small Molecule ◽  
Small Molecule Inhibitors ◽  
Inhibitory Interneuron ◽  
Disulphide Bond ◽  
Neuronal Cultures ◽  
Clostridium Tetani ◽  
Inhibitory Neurotransmitters ◽  
Tetanus Neurotoxin

Tetanus neurotoxin (TeNT) is a protein exotoxin produced by Clostridium tetani that causes the deadly spastic neuroparalysis of tetanus. It consists of a metalloprotease light chain and of a heavy chain linked via a disulphide bond. TeNT binds to the neuromuscular junction (NMJ) and it is retro-axonally transported into vesicular compartments to the spinal cord, where it is released and taken up by inhibitory interneuron. Therein, the catalytic subunit is translocated into the cytoplasm where it cleaves its target protein VAMP-1/2 with consequent blockage of the release of inhibitory neurotransmitters. Vaccination with formaldehyde inactivated TeNT prevents the disease, but tetanus is still present in countries where vaccination coverage is partial. Here, we show that small molecule inhibitors interfering with TeNT trafficking or with the reduction of the interchain disulphide bond block the activity of the toxin in neuronal cultures and attenuate tetanus symptoms in vivo. These findings are relevant for the development of therapeutics against tetanus based on the inhibition of toxin molecules that are being retro-transported to or are already within the spinal cord and are, thus, not accessible to anti-TeNT immunoglobulins.

scholarly journals Cephalic Tetanus from Penetrating Orbital Wound

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Eloïse Guyennet ◽  
Jean-Laurent Guyomard ◽  
Emilie Barnay ◽  
Franck Jegoux ◽  
Jean-François Charlin
Keyword(s):  
Nerve Palsy ◽  
Cranial Nerves ◽  
Facial Trauma ◽  
Clostridium Tetani ◽  
Neurologic Disorder ◽  
Protein Toxin ◽  
Wooden Foreign Body ◽  
Cephalic Tetanus ◽  
The Right ◽  
Complete Ophthalmoplegia

Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.

A Case of Cephalic Tetanus in a Developed Country

2013 ◽  
Vol 26 (1) ◽  
pp. 273-277 ◽  
Author(s):  
S. Fusetti ◽  
C. Ghirotto ◽  
G. Ferronato
Keyword(s):  
Masticatory Muscles ◽  
Skin Wound ◽  
Clostridium Tetani ◽  
Developed Country ◽  
Facial Region ◽  
Presenting Symptoms ◽  
Spasmodic Contraction ◽  
Important Health ◽  
Life Threatening ◽  
Cephalic Tetanus

Tetanus is a potentially life-threatening infection that results from contamination of skin wound by Clostridium Tetani spores. Although, it remains an important health problem in developing countries without strict national immunization programs, this condition is rare in the developed world. The most frequent presenting symptoms are trismus and dysphagia, due to the spasmodic contraction of the masticatory muscles. Then the disease usually diffuses with a descending pattern inducing a generalized contraction of the agonist and antagonistic muscles, which characterize a tetanic spasm. Mortality usually results from respiratory failure, cardiovascular collapse, or autonomic dysfunctions. Treatment usually requires the prompt admission to the intensive care unit to avoid the development of potential life-threatening complications. We report the case of a 78-year-old farmer, who was referred to us with progressive onset of lock-jaw and muscular stiffness of the facial region, that had occurred after he had scratched himself with a rose. The recognition of the presenting signs of cephalic tetanus allowed the prompt management of the infection. However, because of the rarity of this condition, the clinicians may be unfamiliar with the clinical presentation, and be unsuspecting of the diagnosis.

Ultrastructure of periplasmic bodies in gram-negative bacteria

1990 ◽  
Vol 48 (3) ◽  
pp. 640-641
Author(s):  
Xie Nianming ◽  
Ding Shaoqing ◽  
Wang Luping ◽  
Yuan Zenglin ◽  
Zhan Guolai ◽  
...  
Keyword(s):  
Electron Microscope ◽  
Campylobacter Jejuni ◽  
Proteus Mirabilis ◽  
Shigella Flexneri ◽  
Morphological Description ◽  
Gram Negative Bacteria ◽  
Periplasmic Space ◽  
Clostridium Tetani ◽  
Gram Negative ◽  
Brucella Canis

Perhaps the data about periplasmic enzymes are obtained through biochemical methods but lack of morphological description. We have proved the existence of periplasmic bodies by electron microscope and described their ultrastructures. We hope this report may draw the attention of biochemists and mrophologists to collaborate on researches in periplasmic enzymes or periplasmic bodies with each other.One or more independent bodies may be seen in the periplasmic space between outer and inner membranes of Gram-negative bacteria, which we called periplasmic bodies. The periplasmic bodies have been found in seven species of bacteria at least, including the Pseudomonas aeroginosa. Shigella flexneri, Echerichia coli. Yersinia pestis, Campylobacter jejuni, Proteus mirabilis, Clostridium tetani. Vibrio cholerae and Brucella canis.

scholarly journals DESENVOLVIMENTO DE IMUNÓGENO CONJUGADO DE LIPOPOLISSACARÍDEO DE Pseudomonas Aeruginosa E TOXÓIDE TETÂNICO

2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Bruno Gavinho ◽  
Rosangela Rodrigues Dos Santos ◽  
Luiz Felipe Caron ◽  
Maria Rita Sierakowski ◽  
Lucy Ono
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clostridium Tetani

O lipopolissacarídeo (LPS) de Pseudomonas aeruginosa foi conjugado ao toxóide tetânico (TT, toxina inativada do Clostridium tetani) utilizando a técnica de aminação redutiva direta, para o desenvolvimento de uma vacina conjugada (LPS-TT). Avaliou-se a resposta imune in vivo após aplicações intraperitoneais do imunógeno LPS-TT em camundongos Swiss, administrando-se 4 aplicações de LPS-TT com intervalos entre as doses de 14 dias. Avaliou-se o título de anticorpos anti-Pseudomonas produzidos pela técnica de soroaglutinação microscópica. Os grupos que foram imunizados com LPS-TT e com LPS+TT (não conjugado quimicamente) apresentaram resposta de anticorpos aglutinantes superior ao controle imunizado apenas com LPS, e a resposta após o reforço vacinal dos animais imunizados com o conjugado LPS-TT foi 567% superior ao dos animais imunizados com LPS.

scholarly journals Infected open depressed skull fracture complicated with tetanus grade I in an unimmunized child: a rare case report with literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Dzulfikar D. L. Hakim ◽  
Ahmad Faried ◽  
Adila Nurhadiya ◽  
Ericko H. Laymena ◽  
Muhammad Z. Arifin ◽  
...  
Keyword(s):  
Rare Case ◽  
Pediatric Population ◽  
Skull Fracture ◽  
Pediatric Intensive Care ◽  
Toxin Production ◽  
Clostridium Tetani ◽  
Anesthetic Care ◽  
Middle Income ◽  
Depressed Skull Fracture ◽  
Low Middle Income Countries

Abstract Background Tetanus is a rare disease caused by Clostridium tetani, which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low–middle-income countries, tetanus still occurs (mostly in adults) due to the lack of immunization related to religious tenets, cultural belief, or inaccessibility to medical care. In addition, tetanus in the pediatric population shows features which are quite distinct from the adult group. Case presentation We report a case of a 7-year-old girl presented to our institution with a history of falling 10 days prior to admission, with only skin laceration on her forehead. For 1 day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed her as an unimmunized child with an open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw.” Perioperative management of this rare case is reported and discussed. Conclusion The pediatric intensive care of such patients requires halting further toxin production, neutralization of circulating toxin, and control of the clinical manifestation induced by the toxin that has already gained access to the central nervous system. The basic tenets of anesthetic care in such case must be well-managed and planned prior to surgery.

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