Tetanus, also called lockjaw, is a serious infection caused by Clostridium tetani. This bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles.

If Clostridium tetani spores are deposited in a wound, the neurotoxin interferes with nerves that control muscle movement.

The infection can cause severe muscle spasms, serious breathing difficulties, and can ultimately be fatal. Although tetanus treatment exists, it is not uniformly effective. The best way to protect against tetanus is to take the vaccine.

Fast facts on tetanus

Here are some key points about tetanus. More detail and supporting information is in the main article.

  • Tetanus is caused by the Clostridium tetani bacterium
  • The early symptoms of tetanus include diarrhea, fever, and headache
  • Earlier diagnosis predicts better outcomes

Tetanus symptoms usually emerge about 7 to 10 days after initial infection. However, this can vary from 4 days to about 3 weeks, and may, in some cases, may take months.

In general, the further the injury site is from the central nervous system, the longer the incubation period. Patients with shorter incubation times tend to have more severe symptoms.

Muscle symptoms include spasms and stiffness. Stiffness usually starts with the chewing muscles, hence the name lockjaw.

Muscle spasms then spread to the neck and throat, causing difficulties with swallowing. Patients often have spasms in their facial muscles.

Breathing difficulties may result from neck and chest muscle stiffness. In some people, abdominal and limb muscles are also affected.

In severe cases, the spine will arch backward as the back muscles become affected. This is more common when children experience a tetanus infection.

Most individuals with tetanus will also have the following symptoms:

  • bloody stools
  • diarrhea
  • fever
  • headache
  • sensitivity to touch
  • sore throat
  • sweating
  • rapid heartbeat

Wounds should be thoroughly cleaned to prevent infection.

Any cut or wound must be thoroughly cleaned to prevent infection. A tetanus-prone wound should be treated by a medical professional immediately.

A wound likely to develop tetanus is defined as:

Any patient with a wound listed above should receive tetanus immunoglobulin (TIG) as soon as possible, even if they have been vaccinated. Tetanus immunoglobulin contains antibodies that kill Clostridium tetani. It is injected into a vein and provides immediate short-term protection against tetanus.

TIG is just short-term and does not replace the long-term effects of vaccination. Experts say that can be safely administered to pregnant and breastfeeding mothers.

Doctors may prescribe penicillin or metronidazole for tetanus treatment. These antibiotics prevent the bacterium from multiplying and producing the neurotoxin that causes muscle spasms and stiffness.

Patients who are allergic to penicillin or metronidazole may be given tetracycline instead.

In treating muscle spasms and stiffness, patients may be prescribed:

  • Anticonvulsants, such as diazepam (Valium), relax the muscles to prevent spasms, reduce anxiety, and work as a sedative.
  • Muscle relaxants, such as baclofen, suppress nerve signals from the brain to the spinal cord, resulting in less muscle tension.
  • Neuromuscular blocking agentsblock the signals from nerves to muscle fibers and are useful in controlling muscle spasms. They include pancuronium and vecuronium.

Surgery

If the doctor thinks the tetanus prone wound is very large, they may surgically remove as much of the damaged and infected muscle as possible (debridement).

Debridement is the act of removing dead or contaminated tissue, or foreign material. In the case of a , the foreign material may be dirt or manure.

Nutrition

A patient with tetanus requires a high daily calorie intake because of increased muscle activity.

Ventilator

Some patients may need ventilator support to help with breathing if their vocal cords or respiratory muscles are affected.

Most cases of tetanus occur in people who have never had the vaccine or who did not have a booster shot within the previous decade.

Vaccination

The is routinely given to children as part of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) shot.

The DTaP vaccine consists of five shots, usually given in the arm or thigh of children when they are aged:

  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months
  • 4 to 6 years

A booster is normally given between the ages of 11 and 18 years, and then another booster every 10 years. If an individual is traveling to an area where tetanus is common, they should check with a doctor regarding vaccinations.

Do I need a tetanus shot?

Anyone who receives a deep or dirty wound and has not had a booster shot over the last 5 years should have another booster.

A patient in this situation may also be given tetanus immune globulin, which works to prevent infection. It is important that medical attention is sought swiftly as tetanus immune globulin only works for a short time after the injury.

If the patient does not receive treatment, the risk of life-threatening is higher and mortality rates vary from .

Complications may include: