Tetanus in newborns

Tetanus in newborns occurs when the infection remainder of the umbilical cord in case of its processing in unsanitary conditions (on the street, the apartment), as well as in the use of non-sterile instruments. The disease due to lack of active immunization of women.
The incubation period of 1 to 10, more often 3-5 days. The earliest sign is a swallowing disorder, resulting in the feeding of the child becomes impossible. Lockjaw and sardonic smile may be missing. Umbilical tetanus often proceeds with hypothermia (temperature 34,5-35,4 degrees), rarely observed sweating. From the first hours of the disease appears muscle rigidity, which lasts for 2-4 weeks. Often simultaneously with the disorder swallowing develop seizures. Altitude attack seizures noted piercing scream. A peculiar manifestation clonic seizures may be tremor lower lip, chin, language. Most of the children there is a forced posture, connected with the increase of a tone of muscles. All children muscle hypertension is reduced with prolonged asphyxia and atonal condition.
At the height of seizures sharp increase in pulse-rate - 240 VAC, 1 min heart sounds loud and clear. When pneumonia appears muted tones of the heart. During seizures noted arrhythmia.
Before the seizure attack breathing quickens, becomes shallow, irregular, often observed apnea (no breathing). When intense and prolonged convulsions appears cyanosis of the face, lips, extremities. In the first 4 days of the disease can be severe attacks of asphyxia.
Complications: pneumonia, rarely sepsis, aspiration of milk during lactation.
The prognosis depends on the timely initiation of treatment.
Treatment. Enter antitetanus serum intramuscularly to Besedke dose of 12 000 ME. For specific desensitization appoint adsorbed tetanus toxoid 0.5 ml per day of hospitalization and an additional 1-2 times at intervals 2-5 days. Anticonvulsant therapy with the use of chloral hydrate, phenobarbital (luminal) and magnesium sulfate ineffective. The most effective curariform drug - candelin. It is also shown chlorpromazine. When complications prescribe antibiotics, vitamins, gamma globulin, plasma, oxygen. To feed the patient needs through a tube inserted into stomach.