Tetanus history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals, fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. History of recent accident or an injury leading to break in the continuity of the skin in the a contaminated environment is helpful in making a diagnosis.[1][2]

History and Symptoms

The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals, fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. Contamination of the umbilical cord may also be an important history finding.[3][4]

Local Tetanus

  • Injury of the particular area followed by spasmodic contraction limited to the injured area.
  • Contractions of local tetanus may take weeks to subside.
  • Generalized tetanus may be preceded by local tetanus.

Cephalic Tetanus

  • It is a rare form of the disease, occasionally occurring with otitis media (ear infections) in which C. tetani is present in the flora of the middle ear, or following injuries to the head.
  • There is involvement of the cranial nerves, especially in the facial area.

Generalized Tetanus

  • Descending spasm of muscles
  • The first sign is trismus or lockjaw, followed by
    • Stiffness of the neck
    • Difficulty in swallowing
    • Rigidity of pectoral and calf muscles.
  • Other symptoms include
    • Elevated temperature
    • Sweating
    • Elevated blood pressure
    • Episodic tachycardia
  • Spasms may occur frequently and last for several minutes. Spasms continue for 3–4 weeks and complete recovery may take months.
  • History of cephalic or localized tetanus
  • History of injury

Neonatal Tetanus Neonatal tetanus may present with a history of:[5]

  • Generalized tetanus occurring in newborn infants.
  • History of use of non-sterile instrument to cut the umblical stump
  • Umblical stump covered with cow dung or juice etc


The infection causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw, which makes it impossible to open your mouth or swallow. If this happens, you could die of suffocation.

References

  1. "Tetanus | Symptoms and Complications | Lockjaw | CDC".
  2. Anisha Doshi, Clare Warrell, Dima Dahdaleh & Dimitri Kullmann (2014). "Just a graze? Cephalic tetanus presenting as a stroke mimic". Practical neurology. 14 (1): 39–41. doi:10.1136/practneurol-2013-000541. PMID 24052566. Unknown parameter |month= ignored (help)
  3. World Health Organization (2000-11-01). "Maternal and Neonatal Tetanus Elimination by 2005" (PDF). Retrieved 2007-01-26.
  4. Lisa Mitchell, William Adams & Francois Aspesberro (2017). "Case 6: Episodic Stiffness in a 30-month-old Girl". Pediatrics in review. 38 (1): 52–53. doi:10.1542/pir.2014-0142. PMID 28044038. Unknown parameter |month= ignored (help)
  5. Martha H. Roper, Jos H. Vandelaer & Francois L. Gasse (2007). "Maternal and neonatal tetanus". Lancet (London, England). 370 (9603): 1947–1959. doi:10.1016/S0140-6736(07)61261-6. PMID 17854885. Unknown parameter |month= ignored (help)

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