Clostridium tetani

Clostridium tetani

Clostridium tetani is one of the rod-shaped gram-positive bacteria is anaerobic and forms endospores from. C. tetani ( tetanos, gr spasm ) is the causative agent of tetanus (tetanus ). This bacterium is primarily the toxins tetanospasmin after botulinum toxin is the second strongest known bacterial toxin, and tetanolysin.

Discoverer of the bacterium was 1884 Arthur Nicolaier. 1889 succeeded Shibasaburo Kitasato isolation and culture of Clostridium tetani.

Occurrence

Reservoir of Clostridium tetani are earth and wood, and the excreta of cattle and rarely other species. Open wounds can be quickly infected with the bacterium and thus lead to tetanus. The usual vaccination should not protect against infection, but against the tetanus toxin.

Interestingly, this bacteria type Clostridium tetani in non- open wounds ( bruises, contusions ), which the conjecture suggests that the bacterium generally can occur in necrotic processes in the body that occur under exclusion of air, which is much more common in covered wounds, of course, the case is.

Pathogenesis

The causative for the symptoms toxin tetanospasmin is transported along nerves or blood to the gray matter of the spinal cord. There cleaves the synaptobrevin ( VAMP ), which is involved in the release of neurotransmitters. Thereby, the inhibitory synapses of motoneurons are blocked, whereby the nervous system can not inhibitory affect the affected muscle.

Clinical symptoms begin with headache and increased Reflexauslösbarkeit. Gradual follows the training of trismus ( lockjaw by increased tone of the muscles of mastication ), the Risus sardonicus (Devil's grin, caused by the contraction of facial muscles ) and a cramping of the extensor muscles of the trunk, called opisthotonos, and stretching spasms of the trunk and limbs, which by external stimuli are favored. These characters take and can be extremely painful when muscles are contracted clonic and finally the patient in the supine position rests only on your head and heels. Also spine fractures have occurred as a result.

A detailed presentation of the disease tetanus see there.

Therapy

Treatment is by surgical wound revision with extensive debridement. In addition, a high dose of penicillin or broad-spectrum antibiotics, because often there is a mixed infection. In deep, dirty wounds and existing primary immunization and last successful refresh more than 5 years ago is actively immunization with tetanus toxoid. In case of incomplete primary vaccination within the last 10 years or unclear vaccination combined active ( tetanus toxoid ) and passive ( hyperimmunoglobulin ) occurs immunization. In existing primary immunization or booster in the last 5 years no prophylaxis is required.