Neonatal tetanus differential diagnosis

Differential diagnosis : Strychnine poisoning is the only condition that truly mimics generalized tetanus. neonatal tetanus have been reported in the United States since 1989, both in infants born to unimmunized mothers. Differential diagnoses: Strychnine poisoning is the only condition that truly mimics. Although tetanus is an exceedingly rare condition, the differential diagnostic consideration of tetanus has presented to us (HRJ) intermittently at Children's Hospital of Boston; therefore, we have presented this in some detail to provide a base for the clinician who is occasionally concerned about this possibility Which conditions should be included in the differential diagnoses of tetanus (lockjaw)? Updated: Jan 18, 2019 Maternal and neonatal tetanus. Lancet. 2015 Jan 24. 385 (9965):362-70. . Prevots. Tetanus in a subcutaneous drug abuser: ineffectiveness of intrathecal baclofen. Anaesth Intensive Care. 2006 Dec. 34 (6):811-5. [Medline]. Ceneviva GD, Thomas NJ, Kees-Folts D. Magnesium sulfate. Neonatal tetanus should be one of the differential diagnosis of the newborns presenting with poor feeding, seizures, stiffness, cyanosis and weak cry (Tablet 1) (4)

The most common differential diagnoses for tetanus are hypocalcemic tetany, drug- induced dystonias (from drugs such as phenothiazines), meningoencephalitis, strychnine poisoning and trismus due to dental infections DIFFERENTIAL DIAGNOSIS Tetanus can sometimes be confused with the following mimics. Drug-induced dystonias such as those due to phenothiazines — Drug-induced dystonias often produce pronounced deviation of the eyes, writhing movements of the head and neck, and an absence of tonic muscular contraction between spasms

Itzhak Brook, in Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), 2018. Diagnosis and Differential Diagnosis. The diagnosis of tetanus is made from clinical findings in a setting of risk and by excluding other causes of tetanic spasms.Recovery of C. tetani from wounds is not helpful because the presence of this organism does not necessarily indicate toxin production Differential Diagnosis In most cases, the clinical picture of omphalitis is sufficient to make the diagnosis. A patent urachus, which results in direct communication between the bladder and umbilicus can be mistaken for infection due to the persistent drainage from the umbilicus Crisponi syndrome in an Indian patient: a rare differential diagnosis for neonatal tetanus. Crisponi syndrome in an Indian patient: a rare differential diagnosis for neonatal tetanus Am J Med Genet A. 2008 Nov 1;146A(21):2831-4. doi: 10.1002/ajmg.a.32487. Authors Niranjan. In many countries neonatal tetanus is responsible for half of all neonatal deaths due to vaccine-preventable diseases and for almost 14% of all infant deaths. It is estimat-ed that in the 1970s more than 10,000 newborns died annually from neonatal tetanus in the Americas. Neonatal tetanus is prevented by immunization and/or as Neonatal tetanus, with a particularly high mortality, is rare in developed countries but common in the developing world. Neonates present within a week of birth with fever, vomiting and 'convulsions'. Differential diagnoses include sepsis and meningitis

Diagnosis is usually difficult because the symptoms may mimic other neonatal infections as the symptoms are usually alike and culture results do not reveal the offending bacterium. A panel of tests are carried out next with differential diagnosis drew up until the doctor is assured that the case before him is neonatal tetanus Differential Diagnosis & Pitfalls Perinatal asphyxia with hypoxic-ischemic encephalopathy - Patients may present with feeding difficulties and abnormal posturing, but the timing and severity of symptoms is different in patients with tetanus neonatorum (who develop symptoms after the tetanus incubation period of 5-7 days)

Diagnosis of tetanus is based on the physical exam, immunization history, and clinical presentation, while less emphasis is placed on laboratory testing. Differentiating tests include blood, urine, and tissue assays. The spatula test involves touching the oropharynx with a tongue blade and determining if the patient has a gag reflex Two basic forms of tetanus may be distinguished: local and general. Local tetanus consists of spasm and increased muscle tone confined to muscles near the wound; there are no systemic signs. General tetanus is far more frequent. Almost all neonatal tetanus is the general form Even presence of tetanus antibodies is not a reliable indicator of the disease presence. Given this challenge, differential diagnosis is relied upon and various associated conditions are investigated to draw up a conclusion. In case of neonates, it must be differentiated from metabolic disorders (eg: hypocalcaemia), meningitis, seizures, etc Neonatal tetanus is a generalized form of tetanus that occurs in newborns of unimmunized mothers or from infection through a contaminated instrument when cutting the umbilical cord. Infants of immunized mothers generally do not get tetanus due to passive immunity from the mother. Differential Diagnosis. The only condition that mimics.

Newborn Tetanus - an overview ScienceDirect Topic

Clinical tetanus is divided into four symptomatic types: generalized tetanus, local tetanus, cephalic tetanus, and neonatal tetanus. This monograph discusses the diagnostic aspects of each type of tetanus, its pathophysiology, diagnosis, differential diagnosis, and treatment. Preventing tetanus should be a high priority for all primary care. For developing countries, tetanus remains endemic and increasing due to natural disasters like earthquakes and tsunamis. II.Pathophysiology. Tetanus occurs when spores of Clostridium tetani gains access to damaged human cells. After it gets into the body, it creates metalloprotease tetanus toxi

Neonatal Tetanus - YouTube

Which conditions should be included in the differential

Diagnosis had to be differentiated between MSUD and other metabolic disorders and neonatal infections (especially neonatal tetanus because of severe opisthotonos) and generalized seizures of the patient. [ncbi.nlm.nih.gov] Tetanus was frequently confused with neonatal seizures at time of presentation. All infants were delivered at home How to cite this article: Thomas N, Danda S, Kumar M, Jana AK, Crisponi G, Meloni A, Crisponi L. 2008. Crisponi syndrome in an Indian patient: A rare differential diagnosis for neonatal tetanus. Am J Med Genet Part A Tetanus is spasms caused by the presence of bacteria toxins in the nervous system. It is an acute, often fatal disease caused by an exotoxin produced by the bacterium Clostridium tetani. It is not a true infection of the central nervous system Clinical tetanus is divided into four symptomatic types: generalized tetanus, local tetanus cephalic tetanus, and neonatal tetanus. This monograph discusses the diagnostic aspects of each type of tetanus, its pathophysiology, diagnosis, differential diagnosis, and treatment. Preventing tetanus should be a high priority for all primary care. Furthermore, the differential diagnosis of non-immunized children with abdominal rigidity should include generalized tetanus. [ncbi.nlm.nih.gov] A common first sign suggestive of tetanus in older children and adults is abdominal rigidity, although rigidity is sometimes confined to the region of injury

differential diagnosis The clinician should consider other CNS conditions in the differential diagnosis (see Table 2). Although similar to generalized seizures, tetanus causes painful spasms and does not produce a loss of consciousness. 1,17 Tetanus, intracranial bleed, and meningitis all can cause meningismus; meningitis, however, is more. Neonatal tetanus is the second leading cause of death from vaccine preventable diseases among children worldwide. In 2013, neonatal tetanus was estimated to be responsible for 49,000 deaths and accounts for 1% of total child death (42). However, the incidence was small in the United States

Tetanus is a bacterial infection caused by Clostridium tetani, a gram-positive obligate anaerobic bacterium commonly found in soil that enters the body through a contaminated wound.C. tetani produces a neurotoxin that blocks the release of inhibitory neurotransmitters and causes prolonged tonic muscle contractions. It presents with lockjaw, neck stiffness, opisthotonus, rigid abdomen and. Differential Diagnosis & Pitfalls. Strychnine poisoning - Symptoms may mimic tetanus, and serum and urine testing for strychnine should always be performed when tetanus is suspected. Dystonic reactions - Lateral head turning seen in dystonic reactions is rare in tetanus. Benztropine may be administered to rule out a dystonic reaction Differential Diagnosis: Hypocalcemic tetany, reaction to antipsychotic and anti- c. Diagnosis: Clinical history, immunization history and anaerobic culture of suspicious wound or debrided tissue. Diagnosis is usually made clinically by excluding other possibilities. In neonatal tetanus, symptoms appear 4-14 days after birth, averaging 7. In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 Differential diagnosis includes hypocalcemic tetany, phenothiazine reaction, strychnine poisoning, epilepsy, rabies, bacterial meningitis and hysteria. Laboratory Identification The diagnosis of tetanus is clinical, and criteria for neonatal tetanus diagnosis are described in the previous section. The differential diagnosis of neonatal tetanus includes birth asphyxia, hypoglycaemia, hypocalcaemic tetany, and seizures. Few conditions truly mimic generalised maternal tetanus

What are the differential diagnoses for Tetanus

Neonatal tetanus

Differential diagnoses for paresis in goat kids include caprine arthritis encephalitis virus (CAEV) and enzootic ataxia. Enzootic ataxia is also common in lambs. Progressive ataxia and paresis or paralysis is a feature of both diseases. There are two forms of enzootic ataxia (swayback): the neonatal and the delayed types awake. In the diagnosis of neonatal tetanus, the presence of unhygienic child birth practices, social taboos, or improper immunization of pregnant mothers is imperative. Also, the clinical findings in neonatal tetanus, such as rigidity, failure to suck, trismus, fever, and seizures make differential diagnosis easy16,17 For review the differential of tetanus, click here. Epidemiology and Demographics. In 2000 neonatal tetanus was responsible for about 14% (215,000) of all neonatal deaths. In 2008 59,000 newborns worldwide died as a result of neonatal tetanus

The initial differential diagnosis included oropharyngeal infections (e.g. tonsillitis, peritonsillar abscess), botulism, rabies, strychnine poisoning, hypocalcemia, psychogenic causes and tetanus. Based on normal complete blood cell count and chemistry profiles, immunization status and the presence of generalized muscle spasms and a possible. Diagnosis. Doctors can diagnose tetanus by examining the patient and looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus. Treatment. Tetanus is a medical emergency requiring: Care in the hospital; Immediate treatment with medicine called human tetanus immune globulin (TIG) Aggressive wound car DIFFERENTIAL DIAGNOSIS. Diagnosis of tetanus is made clinically. strychnine poisoning; trismus due to orofacial infection; stiff person syndrome; acute dystonic reaction; seizure disorder; hypocalcaemic tetany; psychogenic; meningism; Neonatal tetanus may resemble: Seizures; meningitis; sepsis; INVESTIGATIONS. urinary strychnine to exclude this. Differential diagnosis - dystonic reaction to tricyclics - strychnine poisoning - local temporomandibular diseae - local oral disease - convulsions - tetany - intracranial infections or haemorrhage - psychiatric disorders. Neonatal tetanus - usually follows infection of the umbilical stum

Neonatal tetanus is responsible for over 50% of deaths associated with tetanus. It is caused by poor umbilical hygiene and is entirely preventable by maternal vaccination. It carries a poor prognosis. Neonatal tetanus has been completely eliminated from the UK. Differential diagnosis. Tetanus is a purely clinical diagnosis Tetanus toxemia is caused by a specific neurotoxin produced by Clostridium tetani in necrotic tissue. Almost all mammals are susceptible, although dogs and cats are relatively more resistant than any other domestic or laboratory mammal. Birds are quite resistant; the lethal dose for pigeons and chickens is 10,000-300,000 times greater (on a. CEPHALIC TETANUS This is rare form is due to any injury near head. Incubation period is short (1-2 days). Cranial nerve involvement is the most characteristic feature of this form of tetanus. 22. DIAGNOSIS It is mainly clinical History of non-vaccination is present in most of the cases. In tetanus neonatorum babies are usually delivered at home. Tetanus is characterized by an acute onset of hypertonia, painful muscular contractions (usually of the muscles of the jaw and neck), and generalized muscle spasms without other apparent medical causes. Despite widespread immunization of infants and children since the 1940s, tetanus still occurs in the United States

Neurological Manifestations of an Old Disease: A Case Repor

Tetanus is classified into four symptomatic types: neonatal, generalized, which represents the most frequent form (more than 80%), local and cephalic [1]. The diagnosis is essentially clinical while the treatment needs to be considered a matter of emergency and lifesaving. Although the organism is widely distributed throughout th Differential diagnosis of tetanus may include strychnine poisoning, dental and local infections, malignant hyperthermia, dystonic drug reactions or seizure disorders. 1 In many instances, the diagnosis of tetanus is not entirely straightforward due to ambiguous clinical features which may include fevers, diaphoresis, dysphagia and neck. In neonatal tetanus, age less than 10 days, an incubation period of 6 days or less, the presence of risus sardonicus, opisthotonus, fever, and weight less than 2.5 kg, indicate a poor prognosis and high risk of death Tetanus is an acute infectious disease caused by spores of the bacterium Clostridium tetani.The spores are found everywhere in the environment, particularly in soil, ash, intestinal tracts/feces of animals and humans, and on the surfaces of skin and rusty tools like nails, needles, barbed wire, etc. Being very resistant to heat and most antiseptics, the spores can survive for years Tetanus was first described in Egypt over 3000 years ago and was prevalent throughout the ancient world. Despite the availability of passive immunisation since 1893 and an effective active vaccination since 1923, tetanus remains a major health problem in the developing world and is still encountered in the developed world. There are between 800 000 and 1 million deaths due to tetanus each year.


Tetanus is a serious illness caused by Clostridium bacteria. The bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn. The infection causes painful tightening of the muscles, usually all over the body Cephalic tetanus has a poor prognosis. Neonatal tetanus has a high mortality. 4. All are true. The differential diagnoses are important to know since the diagnosis of tetanus is based on clinical features. 5. a, c, d and e are false. Sedatives are the mainstay of treatment nowadays


Tetanic Spasm - an overview ScienceDirect Topic

Tetanus is a clinical diagnosis. Bacteria may be cultured from a wound (although in most cases this is not possible). Polymerase chain reaction detection of tetanus toxin may also be used as a method of confirming clinical diagnosis.6 Differential diagnosis of botulism GuillaineBarre syndrome Nerve conduction studies, CSF analysi Trismus, commonly called lockjaw, is reduced opening of the jaws (limited jaw range of motion).It may be caused by spasm of the muscles of mastication or a variety of other causes. Temporary trismus occurs much more frequently than permanent trismus. It is known to interfere with eating, speaking, and maintaining proper oral hygiene Most common form of tetanus. Usually begins with trismus (spasm of the masticator muscle group) with gradual onset of spasm of muscle groups in the trunk and extremities. Spasms exacerbated by external stimuli (light or sudden sound) Patients can lose ability to breathe during prolonged spasms. Respiratory failure is main cause of death Significant progress has been made in reducing the incidence of maternal and neonatal tetanus over the last two decades. World Health Organization (WHO) figures estimate that 25,000 newborns died from neonatal tetanus in 2018, an 88% reduction from the situation in 2000

Tetanus 120405220242-phpapp01

Omphalitis - StatPearls - NCBI Bookshel

  1. ated. Laboratory diagnosis.
  2. The diagnosis is supported by an incomplete or out-of-date vaccination status, culture of C. tetani from the wound, detection of circulating tetanus toxin and the absence of tetanus toxin antibodies. Complications of tetanus arise either as a direct result of the disease or due to the intensive care management
  3. Tetanus (Greek tetanos, to contract) is a central nervous system disease manifesting as severe muscular contractions sufficient to produce respiratory compromise and death caused by a neurotoxin released by Clostridium tetanithat is generated under anaerobic conditions from a spore inoculated into a wound.Worldwide currently there are an estimated 293,000 deaths annually (18,000 neonatal.
  4. Diagnosis and recommended emergency room treatment and management of diphtheria, pertussis, and tetanus, including isolation protocol and obtaining diphtheria antitoxin from the CDC. Includes 4 AMA PRA Category 1 Credits ™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME and 1 Pharmacology CME credits
  5. It is seldom possible to find either the bacterium or the toxin in a suspected tetanus patient, so diagnosis can be made only on the basis of clinical observations combined with an individual's.
  6. Tetanus neonatorum causes more than 50% of deaths from tetanus worldwide 43 but is very rare in developed countries. 78 Neonates present within a week of birth with a short history of failure to feed, vomiting, and 'convulsions'. Seizures, meningitis, and sepsis are differential diagnoses (Figs 5 and 6). Spasms are generalized and mortality.

Crisponi syndrome in an Indian patient: a rare

Furthermore, the differential diagnosis of non-immunized children with abdominal rigidity should include generalized tetanus. [ncbi.nlm.nih.gov] A common first sign suggestive of tetanus in older children and adults is abdominal rigidity, although rigidity is sometimes confined to the region of injury.Generalized spasms occur, frequently induced by sensory stimuli Neonatal tetanus can occur as a result of inadequate maternal immunity or poor hygiene, especially around the necrotic umbilical stump. DIAGNOSIS Is based on the finding of characteristic muscle spasms in an awake person with a wound and an inadequate immunization history Tetanus Pitfalls Common pitfalls include: History of vaccination does not exclude the diagnosis Failure to recognise that trismus is characteristic of tetanus Failure to perform the spatula test Laryngospasm may be severe and occur without warning, or may be precipitated by stimulation Severe muscular spasms may compromise respiration Administration of penicillin when metronidazole is the [


generalized tetanus in which case it has a similarly poor prognosis (3). The tetanus clinical syndrome is similar to that caused by strychnine poisoning (2). The differential diagnosis depends on the clinical form of tetanus and the presenting symptoms (2). Cephalic tetanus may be confused with Bell's palsy and trigeminal neuritis (2) Tetanus. acute bacterial infection caused by Clostridium tetani . anaerobic gram-positive, spore-forming bacteria found in soil , geminate and produce tetanospasmin. Characterized by. : an acute onset of hypertonia, painful muscular contractions (jaw and neck), and. generalized muscle spasms DIAGNOSIS • The spatula test is one diagnostic bedside test. • This test involves touching the oropharynx with a spatula or tongue blade.This test typically elicits a gag reflex, and the patient tries to expel the spatula (ie, a negative test result). If tetanus is present, patients develop a reflex spasm of the masseters and bite the spatula (ie, a positive test result)

Neonatal tetanus by Dr Afuye Olubunmi Olusola

Here's how unhygienic care of the newborn's umbilical cord

TETANUS • • • • Learning Objectives Introduction Impact of tetanus Clinical features Infection and action Botulism and tetanus Clinical presentation Differential Diagnosis Treatment Halting toxin production Immunisation Supportive treatment Key Points Summary Questions Tetanus Angela Houston is a specialist registrar in Infectious disease, microbiology and virology in London and the. Produces unrestrained reflex activity of skeletal muscles & autonomic nervous system. Spores resistant to: Heat, usual antiseptics & chemical agents. Spores destroyed by: Autoclaving at 120°C for 15 minutes; Boiling for at least 4 hours. Animals: Horses, sheep, cattle, dogs, cats, rats, chickens A young boy coughing due to pertussis. Incubation period several days-3 weeks. 3 stages: Catarrhal phase: lasts 1-2 wks. Clinically indistinguishable from other URIs; dry cough starts near the end. Greatest infectivity phase. Paroxysmal phase: lasts 2-4 weeks. Fever improves, cough worsens Tetanus Definition There are four patterns of disease: Generalised tetanus Defined as mild to moderate trismus (Lockjaw), and one or more of the following: spasticity, dysphagia, respiratory embarrassment, spasms or autonomic dysfunction. Localised tetanus Increased rigidity and spasm of muscle groups adjacent to the site of infection. If it remains localised it has a good [

TetanusPPT - Tetanus PowerPoint Presentation - ID:2171027NEONATAL SYNDROMES | Veterian Key

The major differential diagnostic considerations for generalized tetanus are strychnine intoxication and the stiff-person syndrome. Strychnine poisoning patients may have relative relaxation of the abdominal musculature between spasms, whereas tetanus patients tend to have diffuse muscular hypertonicity at all times Most common diagnosis in children is middle ear infection 80-90% of children have it at least once by age 3 Causation: some viral infections, mostly bacterial (Gram + & -) S. pneumoniae, H. influenzae, and M. catarrhalis Bacteria migrate to middle ear from nasopharynx Can lead to epiglottitis, pneumonia, and meningitis Signs & Symptoms Tetanus - the White Book - revised February 2017 Differential Diagnosis Neonatal tetanus Meningitis, kernicterus, birth asphyxia Non Neonatal Tetanus Rabies (hydrophobia, marked dysphagia, clonic seizures, CSF pleocytosis) Hypocalcaemia (trismus will be absent) Parapharyngeal, retropharyngeal or dental abscess (trismus Neonatal tetanus carries an extremely high mortality rate and results from inadequate maternal immunization and poor umbilical cord care. + + + Diagnosis and Differential + + Tetanus is diagnosed clinically. Prior immunization does not eliminate tetanus as a diagnostic possibility. There are not any confirmatory laboratory tests Diagnosis. Doctors can diagnose tetanus by examining the patient and looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus. Treatment. Tetanus is a medical emergency requiring: Care in the hospital; Immediate treatment with medicine called human tetanus immune globulin (TIG) Aggressive wound car