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- Oxygen-labile hemolysin (tetanolysin)- Plasmid-encoded, heat-labile neurotoxin (tetanospasmin)o Light (A) chain - responsible for proteolytic activity, stopping inhibitor irritation in the motor neuron synapse (gamma-aminobutyric acid (GABA))® spastic paralysiso Heavy (B) chain - responsible for attachment to neuron membraneTheir role in the pathogenesis of infections:- C. tetani remains and reproduces only in the portals of entry where there are dead tissues and where microorganism spores have appeared and germinated; vegetative forms produce toxins, which have an affinity to the nervous system; the toxin attaches to the terminal part of the peripheral nerves and spreads to the CNS- Generalized tetanus - most common form; involvement of the masseter muscles (trismus or lockjaw)- Localized tetanus - disease remains confined to the musculature at the site of primary infectiono Cephalic tetanus - primary site of infection is head; the prognosis with cephalic tetanus is very poor- Neonatal tetanus (tetanus neonatorum)
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