Tuesday, 26 May 2015

Neonatal Tetanus

Tetanus Neonatorum : Generalized paucity of movement associated with stiffness and rigidity or spasms (Opisthotonos).Trismus (lockjaw) is the reason of feeding difficulty. Baby is on Oxygen due to affection of respiratory muscles.
2. Management:
1. Ensure patent airway
2. Respiratory support as required
3.Ensure nutrition and hydration
4. Human tetanus immunoglobulin (TIG) as soon as possible to neutralize the toxin
A single IM of 500 U of TIG is sufficient to neutralize systemic tetanus toxin, but total doses as high as 3,000–6,000 U are also recommended. Tetanus toxin cannot be neutralized by TIG after it has begun its axonal ascent to the spinal cord.
5. Diazepam for both muscle relaxation and seizure control. Other muscle relaxants can be used like Baclofen as well.
6. Penicillin G to eradicate Clostridium tetani. 100,000 U/kg/day divided every 4–6 hr IV for 10–14 days
7. Excision of the umbilical stump is no longer recommended but, good cleaning

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