Which of the following are true about tetanus ?

Ans. is 'b' i.e., Because of tetanospasmin Clostridium tetani is a gram (+)ve, spore forming, anaerobic bacillus. Tetanospasmin (neurotoxin) is responsible for tetanus. Tetanus is characterized by increased muscle tone (muscle spasm) and rigidity. Diagnosis of tetanus The diagnosis of tetanus is based entirely on clinical findings. The diagnosis is established on the basis of history of an injury, (paicularly one in which either soil or fecal material has been introduced) 6-12 days before the onset of typical clinical findings. Wound should be cultured in suspected cases. However, C. tetani can be isolated from wounds of patients without tetanus and frequently cannot be recovered from wounds of those with tetanus. Other laboratory findings may be - i) There may be leukocytosis ii) Muscle enzyme levels may be raised iii) Electromyogram may show continuous discharge of motor units and shoening or absence of the silent interval normally seen after an action potential. Treatment of tetanus Treatment of tetanus includes :? 1) Antimicrobial therapy :- Antibiotic therapy is administered to eradicate vegetative cells, i.e. to eliminate the source of toxins. Penicillin and metronidazole are first line drugs. Clindamycin and erythromycin are alternatives for penicillin - allergic patients. (Tetracycline is not used). 2) Antitoxin :- is given to neutralize circulating toxin. Human tetanus immune globuline (TIG) is the preparation of choice. 3) Control of muscle spasms :- Many agents, alone or in combination, have been used to treat the muscle spasms of tetanus, which are painful and can threaten ventilation by causing laryngospasm or sustained contraction of ventilatory muscles. Benzodiazepines (Diazepam, larazepam, midazolam) are used most commonly. Alternatives are Barbiturates and chlorpromazine. Mechanical ventilation with a nondepolarizing neuromuscular blocking agent may be used for spasms unresponsive to medications. Other agents include propofol, dantrolene, intrathecal beclofen, succinylcholine and magnesium sulfate. 4) Respiratory care :- Intubation or tracheostomy, with or without mechanical ventilation may be required. 5) Autonomic dysfunction :- For sympathetic overactivity labetalol, esmolol or clonidine may be used. Vaccine :- Patient recovering from tetanus should be actively immunized