Neonatal Tetanus

Definition: infectious disease that causes toxins of the bacteria Clostridium tetani that manifests the muscle spasms and muscle stiffness followed by the entire body.

Clinical symptoms:
• Preceded by muscle tension, especially in the jaw and neck
• Occur difficulty opening the mouth (trismus)
• Continue to nape muscle cramps, abdominal wall, and along the spine
• General description of typical: with opstotonus rigid body, legs in extension, rigid arms and clenched hand, awareness is still good.

The main factors of neonatal Tetanus is a habit of using a childbirth aid and traditional medicines that are not sterile. In the central nervous system, tetanospasmin toxin produced by bacteria Clostridium tetani. the toxin binds to receptors of prasinaps membrane in motor neurons and then moves through a system of retrograde axonal transport to neuronal cell bodies into the spinal cord and brain stem. The toxin diffuses to terminals of inhibitory cells, including interneuron glisinergik and aminobutirat acid-secreting neurons from the brainstem. Reduce toxin sinaptobrevin, a protein that is involved in neurotransmitter vesicle membrane binding prasinaps. These toxins will block the impulse

Paralysis, motor function disorders caused by lesions of the mechanism of nerve and muscle;

and muscle spasm can be developed on the location of the lesion and if not treated will develop into generalized. Generalized tetanus is the most common form of tetanus is characterized by rigidity, muscle spasms and autonomic dysfunction.

Masseter muscles spasm causes trismus (locked jaw). Spasm progressively extended to the facial muscles that cause facial expressions and typical spread to the muscles for swallowing. Rigidity of the neck muscles causes retraction head while the body causing muscle rigidity and disturbances opistotonus respiration with decreasing flexibility of the chest wall, then causes the tendon reflexes in the increase.

In addition to increased muscle tone (rigidity), there are episodic muscle spasms that cause pain. These contractions may be spontaneous or stimulated by touch, visual stimuli, auditory (sound suddenly), light or emotional. Spasm of the muscles around the mouth developed into risus sardonikus while spasm of the muscles of the spine and legs evolved into opistotonus (head and heels bent toward the back of each other)


Clostridium tetani Characteristic:• Gram positive bacteria • Obligate anaerobes• Type of Clostridium tetani differentiated based on specific antigen flagell • Usually is O (somatic) antigens dams produce the same type of antigen neurotoxin, tetanospasmin

Habitat• In the soil, feces of horses and other animals • Entry into the traumatized skin


Pathogenesis C.tetani not invasive organisms. Infection remains localized on the area of damaged tissue (in trauma) where spores enter. Danpertumbuhan spore germination vegetative organisms that produce toxin in aid by necrotic tissue, calcium salts, pyogenic infection. Toxin stimulated by vegetative cells that reach CNS receptors then quickly achieve spinal cord and brainstem The incubation period of 4-5 days in each week.
Treatment Hyperimune human globulin, penicillin C.tetani inhibit growth and toxin production stopped, antibiotics inhibit the pyogenic infection.


Prevention Depends on: a. Active immunization with toxoid b. Injury protection c. Pennicilin d. The use of antitoxin


C.tetani life cycle
1.Clostridium tetani bacteria have spores. These bacteria will spread their spores when their environment becomes worst and will go back into vegetative cells when conditions are good. 2. Spores began to divide and separate themselves 3. Spores had divided and separated themselves and formed the spore coat, due to the bad condition of the bacteria began to lysis. 4. Spore coat of spores which have a spore wall will form within the mother spore. 5. Spore lysis and the resulting spore become free and already has a complete structure. 6. Spores were brought by the vector. 7 Spores enter the host. 8. Spore wall will be a wall of the bacteria.