Signs of Tetanus

Description

A serious illness caused by the bacteria Clostridium tetani. The spores of the bacteria remain dormant in soil, dust and manure. The spores usually enter the body through a deep cut. Once in the body the bacteria begin multiplying and releasing a toxin (tetanospasmin). This toxin blocks the nerves to the muscles causing muscle spasms including the muscles of the jaw leading to the common term "lock jaw". These spasms can be severe enough to cause broken bones and if the breathing muscles are involved death can occur from suffocation. The symptoms usually appear 7 days after the injury.

Symptoms

Spasms of the jaw, neck and other muscles causing: jaw stiffness, neck stiffness, problems swallowing, difficulty breathing, chest tightness, pain in the abdominal and back muscles. Breathing problems can be severe enough to result in death.

Tests

A history and physical exam will be done. The diagnosis is made by the history and the symptoms being experienced. Lab and imaging tests are generally not helpful in confirming the disease, but are often done to detect damage to other body parts.

Standard Workup

CBC
Chem 12
UA
X-Ray

Treatment

Therapy is aimed at: removing any toxin that has not already damaged the nerves, destroying the bacteria producing the toxin, preventing future cases of tetanus, and treating the damage that has already occurred. Tetanus immune glogulin (TIG) is given to remove any leftover toxin, antibiotics are administered to kill the Clostridium tetani bacteria, and tetanus vaccine is given to prevent future infections. Treatment typically requires long periods in the intensive care unit. Medications to help the muscles relax and to relieve pain are often given, and some patients require a breathing tube and mechanical ventilation. Immunization can help prevent the infection. Children should receive their first shots at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years. During this time the immunization is usually combined with diphtheria and pertussis protection as the DTP or DTaP immunization. Boosters are recommended at 11 and 18 years old then every 10 years as an adult. If a patient is inadequately immunized as a child and they suffer a wound susceptible to tetanus the provider may administer the TIG and tetanus vaccine during the initial wound care.