Tetanus after surgery

Introduction The disease is a tetanus due to surgical infection and is a type of tetanus. Initial fatigue, headache and discomfort, followed by facial muscle spasm and difficulty opening, and gradually appear paroxysmal twitching of the back muscles and body muscles, while sweating and breathing distress, but conscious. This disease still has a high mortality rate. Local type tetanus, the tonic contraction of the muscle is limited to the vicinity of the wound or the injured limb, the general incubation period is longer, the symptoms are lighter, and the prognosis is better.

Cause

Cause: A acute specific infection caused by tetanus invading human wounds, growing and reproducing, and producing toxins. The patient has severe headache, high fever, jet vomiting, etc., and the mind is sometimes unclear. Cerebrospinal fluid examination has increased pressure and increased white blood cell count. Clostridium tetani has no invasiveness, does not invade the blood circulation, and only grows in local wounds. Its pathogenic effect is mainly caused by the produced exotoxin. Exotoxin mainly invades the spinal cord and brainstem motor neurons, and once combined with nerve cells, it cannot be neutralized by tetanus antitoxin. After invasive local wounds, Clostridium tetanus spores generally do not grow and reproduce. If there is a combination of aerobic bacteria and purulent infection, local blood circulation caused by severe tissue trauma, or necrotic tissue and foreign matter retention, forming a local anaerobic microenvironment, it is very beneficial to the breeding of Clostridium.

an examination

Related inspection

Blood test neck stiffness

diagnosis:

1. Incubation period: varies in length, often related to whether it has received vaccination, the nature and location of the wound and the treatment of the wound. Usually 7-8 days, but also short 24 hours or as long as months or years.

2. Prodromal period: fatigue, dizziness, headache, chewing weakness, hyperreflexia, irritability, local pain, muscle traction, convulsions and rigidity, jaw weakness, mouth inconvenience.

3. Attack period: continuous muscle contraction. Initially, it is a masticatory muscle. The later order is the face, neck, back, abdomen, limbs, and finally the diaphragm and intercostal muscles.

4. Paroxysmal spasm can be induced by sound, light vibration, drinking water and injection. The patient's mind is always clear and there is no abnormality. Generally no high heat.

Differential diagnosis

Differential diagnosis of tetanus after surgery:

1. Suppurative meningitis: Although there are symptoms such as "angular arch reversal" and neck stiffness, but no paroxysmal spasm, patients have severe headache, high heat jet vomiting, etc., the mind is sometimes unclear, cerebrospinal fluid examination has increased pressure , white blood cell count increased.

2. Rabies: There is a history of bites by mad dog cats, mainly pharyngeal muscle twitching, pharyngeal muscle stress is enhanced, the patient hears the sound of water or sees the water pharyngeal bone immediately sputum, the painful water can not swallow, and a lot of flow Mouth.

3. Others: such as temporomandibular arthritis, eclampsia, rickets and so on.

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