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Neonatal tetanus
Introduction
Introduction Neonatal tetanus (tetanus of newborn) is an acute infectious disease caused by the invasion of tetanus anaerobic spores from the umbilicus. It is often caused by symptoms about 7 days after birth. It is characterized by the rigidity of the whole body skeletal muscle and the tightness of the teeth. Therefore, it is called the "umbilical wind", "seven-day wind" and "locking wind". The incubation period is 3 to 14 days, mostly 4 to 7 days. The shorter the period, the heavier the disease and the higher the mortality rate. The early symptoms are crying, mouth is not big, and it is difficult to eat milk. If the tongue is pressed with a tongue depressor, the stronger the force, the more difficult it is to open the mouth, which is helpful for early diagnosis. Then the jaws were closed, the facial muscles were tense, and the mouth was pulled, showing a "chat smile" face, accompanied by a burst of double fists. Excessive flexion of the upper limbs, straightening of the lower extremities, angulation of the horns, respiratory muscles and larynx tendon can cause suffocation of bruising. When the seizure occurs, the child is conscious of the characteristics of the disease. Any slight irritation can induce seizures. After a reasonable treatment for 1 to 4 weeks, the hernia is gradually relieved, the interval between episodes is prolonged, and the milk can be sucked up. It takes about 2 to 3 to recover completely. Months. Pneumonia and sepsis are often complicated during the course of the disease.
Cause
Cause
The main cause of the disease is to cut the umbilical cord with scissors that have not been strictly disinfected during delivery, or the hands of the birth attendant are unclean, or do not pay attention to the cleaning and disinfection of the umbilicus after birth, resulting in neonatal tetanus, also known as "four six winds" and "seven" Japanese wind or "umbilical wind". Usually, when the umbilical cord is delivered, the umbilical part is caused by the invasion of the umbilical cord because the hand of the birth attendant or the scissors and gauze used are not sterilized or disinfected. Most occur 4 to 7 days after birth.Examine
an examination
Related inspection
Neck straight knee reflex
Blood around
It can be infected with bloody nucleus due to secondary infection of umbilical cord or persistent stress, and neutrophils are elevated.
2. Bacterial culture
Tetanus secretion culture can isolate tetanus, but only some of the children are positive.
3. Cerebrospinal fluid
Cerebrospinal fluid examination is normal.
4. X-ray chest
The examination can determine whether there is a secondary pulmonary infection.
5. Brain CT
No obvious abnormalities, no intracranial hemorrhage, can be identified with convulsions caused by neonatal intracranial hemorrhagic disease.
6. EEG examination
No obvious abnormalities.
Diagnosis
Differential diagnosis
1. Suppurative meningitis: Although there are angular reflexes, strong back and other symptoms, but no paroxysmal muscle twitching, patients with increased intracranial pressure, accompanied by severe headache, jet vomiting, high fever, lethargy. Cerebrospinal fluid examination can be identified.
2. Rabies: There are many cases of rabies and cat bites, which are mainly caused by swallowing muscle twitching, and produce what is called hydrophobia in clinical practice. The diaphragm contracted and produced a loud rebellion like the sound of a canine.
3. Hand and foot convulsions: Strong sputum is mainly limited to the hands and feet, but no teeth close tight and bitter smile.
4. Neonatal seizures: Not necessarily in 4 to 8 days of onset, generally no mouth and lips, face is a bitter smile, etc., caused by a variety of causes, can detect the primary disease.
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