Question - Tetanus is a life threatening disease characterized by generalized increased rigidity and convulsive spasms of skeletal muscles. What is the pathophysiology of this toxin caused disease?
Answer- The cited reference notes “Tetanus is caused by the spore-forming bacterium Clostridium tetani. Spores of C. tetani (the dormant form of the organism) are found in soil contaminated with animal and human excreta. The spores enter the body through breaks in the skin, and germinate under anaerobic conditions. Puncture wounds and wounds with a significant amount of tissue injury are more likely to promote germination. The organisms produce a potent toxin, tetanospasmin, which binds to gangliosides at the neuromuscular junction and proceeds along the neuron to the ventral horns of the spinal cord or motor horns of the cranial nerves in 2–14 days. The toxin can also be absorbed into the blood stream and lymphatics. Once the toxin reaches the nervous system, it causes painful and often violent muscular contractions. The muscle stiffness usually initially involves the jaw (lockjaw) and neck, and later becomes generalized. Tetanus is a non-communicable disease—it is not transmitted from 1 person to another.” (https://www.cdc.gov/vaccines/pubs/surv-manual/chpt16-tetanus.pdf; accessed: January 2019)