TetanusDRG Category 423

Mean LOS: 7.1 days Description: MEDICAL: Other Infectious and Parasitic Diseases Diagnoses

Tetanus, or lockjaw, is a preventable but often fatal disorder that is caused by the bacterium Clostridium tetani, a spore-forming anaerobe. The bacterium exists in spore form in an aerobic environment until it is exposed to an anaerobic environment. The organism then changes to the vegetative form, multiplies, and produces neurotoxins.

884 Tetanus

When the tetanus bacteria enter an open wound, they multiply and produce a potent neurotoxin called tetanospasmin, which enters the bloodstream and acts on the spinal ganglia and central nervous system by interfering with the function of the postsynaptic inhibitory potentials. The anterior horn cells become overstimulated, thus resulting in excessive muscle contraction. Toxins may also act directly on skeletal muscle and cause muscle contraction. Complications include lung disorders such as pneumonia, pulmonary emboli, atelectasis, cardiac dysrhythmias, gastric ulcers, and flexion contractures. Tetanus results in approximately 5 deaths per year in the United States; death usually results from autonomic dysfunction such as extremes in blood pressure, cardiac dysrhythmia, or cardiac arrest.

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