Bacterial Toxins
Diphtheria
Diphtheria exotoxin binds to receptors on peripheral nerves, inhibits protein synthesis. Demyelinating neuropathy more likely with severe infection.
Palatal and pharyngo-laryngo-esophageal paralysis early; prominent signs in pharyngeal infection. See also Chapter 106.
Tetanus
Tetanus toxin (tetanospasmin) blocks synaptic release of neurotransmitters at the neuromuscular junction, autonomic terminals, and in the CNS, causing local or generalized muscle spasms.
Epidemiology
Clostridium tetani spores ubiquitous in environment. Entry via puncture wounds, compound fractures, firearms or fireworks wounds, contamination of operative wounds, burns, parenteral injections (particularly in intravenous drug users), through umbilicus of newborn infant.
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