Van Driessche A, Janssens B, Coppens Y, Bachmann C, Donck J
Acta Clin Belg. 2013 Nov-Dec;68(6):416-20. doi: 10.2143/ACB.3336.
Tetanus is a very serious neuromuscular disease caused by a powerful exotoxin, tetanospasmin, from the Clostridium tetani bacillus. Its incidence in the developed world has diminished considerably since the introduction of primary vaccination. Tetanus is diagnosed clinically, through recognition of the characteristically inducible muscle spasms. Three clinical forms described in adults are generalised, localised and cephalic tetanus. Management of tetanus aims at removing the source of tetanospasmin, neutralising circulating toxin, and providing adequate supportive care for muscle spasms, respiration and autonomic instability. Tetanus is a forgotten disease in developed countries since many practicing primary care physicians have not seen a single case in their career. We present a case of tetanus and review briefly the pathogenesis, clinical features and therapy in order to educate the internist in recognising and adequately treating this disease.
破伤风是一种由破伤风杆菌产生的强效外毒素——破伤风痉挛毒素引起的非常严重的神经肌肉疾病。自引入初级疫苗接种以来，其在发达国家的发病率已大幅下降。破伤风通过识别典型的可诱发肌肉痉挛进行临床诊断。成人中描述的三种临床类型为全身性、局限性和头部破伤风。破伤风的治疗旨在消除破伤风痉挛毒素的来源，中和循环毒素，并为肌肉痉挛、呼吸和自主神经不稳定提供充分的支持性护理。破伤风在发达国家是一种被遗忘的疾病，因为许多执业初级保健医生在其职业生涯中从未见过一例。我们报告一例破伤风病例，并简要回顾其发病机制、临床特征和治疗方法，以便教育内科医生识别和充分治疗这种疾病。
