Tetanus tissue damage

Puncture wounds do not cause a large area of visible injury to the skin but can carry a risk of damage to underlying tissues and infection. Puncture wounds should be cleansed carefully and monitored for signs of infection. The need for a tetanus toxoid booster immunization should be assessed. 

Diphtheria toxin, which is considerably less toxic than either tetanus or botulinus toxins, seems to be less specific in its action and is capable of causing damage to almost any tissue or organ in the susceptible animal. 

In addition to the classical exotoxins, which damage tissues of susceptible animals in concentrations approximating one molecule per cell, many bacteria excrete extracellular enzymes during their growth which may be more or less toxic. Although none of these extracellular enzymes has been isolated in pure form as yet, it appears probable that their toxic dose is relatively large and the latent period of their action relatively short as compared with tetanus, botulinus, or diphtheria toxins. 

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