157.4 📌 章末速蚘

  • C. tetani — drumstick spore, soil/wound
  • Tetanospasmin → 阻 GABA/glycine → spastic paralysis
  • Trismus + risus + opisthotonos + autonomic storm
  • Treatment: TIG + debridement + metronidazole + BZD + ICU
  • Magnesium sulfate for spasm + autonomic
  • Wound prophylaxis: dirty + > 5y or < 3 doses → Td (+ TIG if uncertain)
  • Vaccine in recovery (感染䞍 confer immunity)
  • 4 forms: generalized 80%, localized, cephalic, neonatal