TETANUS is a topic covered in the Harrison's Manual of Medicine.

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Microbiology, Epidemiology, and Pathogenesis

Tetanus is characterized by increased muscle tone and spasms caused by tetanospasmin (“tetanus toxin”), a toxin produced by Clostridium tetani.

  • C. tetani is a spore-forming, anaerobic gram-positive rod that is ubiquitous in soil and whose spores are highly resilient.
  • Tetanus is a rare disease in the developed world: only 231 cases were reported in the United States between 2001 and 2008. Most cases occur in incompletely vaccinated or unvaccinated individuals.
  • After spores contaminate wounds (typically puncture wounds or, in the case of neonates, the umbilical stump) and reach a suitable anaerobic environment (e.g., devitalized tissue), organisms proliferate and release toxin.
    • The toxin blocks release of inhibitory neurotransmitters (glycine and γ-aminobutyric acid) in presynaptic terminals, and rigidity results from an increased resting firing rate of the α-motor neurons.
    • A toxin dose as low as 2.5 ng/kg can be fatal.

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Citation

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TY - ELEC T1 - TETANUS ID - 623240 ED - Fauci,Anthony S, ED - Hauser,Stephen L, ED - Jameson,J Larry, ED - Kasper,Dennis L, ED - Longo,Dan L, ED - Loscalzo,Joseph, BT - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623240/all/TETANUS PB - McGraw Hill Inc. ET - 19 DB - Harrison's Manual of Medicine DP - Unbound Medicine ER -