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Tétano

Última revisão: 17 Aug 2025
Última atualização: 25 Feb 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • lesão prévia propensa a tétano
  • estado da imunização antitetânica
  • trismo (mandíbula travada)
  • dorsalgia
  • rigidez/aumento do tônus muscular
  • disfagia
  • espasmos
Detalhes completos

Outros fatores diagnósticos

  • usuários de drogas injetáveis
  • dificuldade respiratória
  • pressão arterial, frequência de pulso e temperatura instáveis
  • sudorese
Detalhes completos

Fatores de risco

  • imunização antitetânica incompleta
  • lesão
  • práticas obstétricas assépticas
  • usuários de drogas injetáveis
  • injeção intramuscular sem assepsia
  • cirurgia abdominal
  • acupuntura, piercing de orelha, pedicuro, palitos de dente
  • tumores necróticos
  • infecção da orelha média
Detalhes completos

Investigações diagnósticas

Investigações a serem consideradas

  • diagnóstico clínico
  • toxina sérica
  • detecção do Clostridium tetani a partir do tecido da ferida ou swab
  • anticorpos séricos antitoxina
  • esporos em amostras de drogas ou objetos relacionados a esta prática
  • punção lombar
  • eletroencefalograma
  • eletromiografia
Detalhes completos

Algoritmo de tratamento

Inicial

ferida limpa e pequena

ferida propensa a tétano

AGUDA

com tétano clínico

Colaboradores

Autores

Russell W. Steele, MD

Clinical Professor of Pediatrics

Tulane University School of Medicine

New Orleans

LA

Declarações

RWS declares that he has no competing interests.

Agradecimentos

Dr Russell W. Steele would like to gratefully acknowledge Dr Christopher M. Parry, Dr Nicholas J. Beeching, Dr Lucy E. Cottle, and Professor Enitan D. Carrol, the previous contributors to this topic.

Revisores

Louise Thwaites, BSc, MBBS, MD

Senior Clinical Research Fellow

Oxford University Clinical Research Unit

Hospital for Tropical Diseases

Ho Chi Minh City

Vietnam

Centre for Tropical Medicine and Global Health

Oxford University

Oxford, UK

Declarações

LT is an author of a number of references cited in this topic.

Katrina Kretsinger, MD, MA

Commander

U.S. Public Health Service

Medical Epidemiologist

HIV Vaccine Team

Epidemiology Branch

Division of HIV/AIDS Prevention

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Centers for Disease Control and Prevention

Atlanta, GA

利益声明

KK declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

UK Health Security Agency. Tetanus: the green book, chapter 30. Jun 2022 [internet publication].全文

Centers for Disease Control and Prevention. Child and adolescent immunization schedule by age: recommendations for ages 18 years or younger, United States, 2025. Nov 2024 [internet publication].全文

Centers for Disease Control and Prevention. Adult immunization schedule by age: recommendations for ages 19 years or older, United States, 2025. Nov 2024 [internet publication].全文

Havers FP, Moro PL, Hunter P, et al. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: updated recommendations of the Advisory Committee on Immunization Practices - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):77-83.全文  摘要

Tiwari TSP, Moro PL, Acosta AM. Tetanus. In: Hall E, Wodi AP, Hamborsky J, et al, eds. Centers for Disease Control and Prevention. Epidemiology and vaccine-preventable diseases. 14th ed. Washington, D.C.: Public Health Foundation; 2021.全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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