Tetanus

Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles.

There’s no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve. Fatality is highest in individuals who haven’t been immunized and in older adults with inadequate immunization.

Symptoms

Common signs and symptoms of tetanus, in order of appearance, are:

  • Spasms and stiffness in your jaw muscles
  • Stiffness of your neck muscles
  • Difficulty swallowing
  • Stiffness of your abdominal muscles
  • Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light

When to see a doctor

See your doctor to obtain a tetanus booster shot if you have a deep or dirty wound and you haven’t had a booster shot within the past five years or aren’t sure of when your last booster was. Or see your doctor about a tetanus booster for any wound — especially if it may have been contaminated with dirt, animal feces or manure — if you haven’t had a booster shot within the past 10 years or aren’t sure of when you were last vaccinated.

Causes

The bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces.

Risk factors

In addition, certain factors are necessary for tetanus bacteria to proliferate in your body. These include:

  • Lack of immunization or inadequate immunization — failure to receive timely booster shots — against tetanus
  • A penetrating injury that results in tetanus spores being introduced to the wound site
  • The presence of other infective bacteria
  • Injured tissue
  • A foreign body, such as a nail or splinter
  • Swelling around the injury

Tetanus cases have developed from the following types of injuries:

  • Puncture wounds — including from splinters, body piercings, tattoos, injection drugs
  • Gunshot wounds
  • Compound fractures
  • Crush injuries
  • Burns
  • Surgical wounds
  • Injection drug use
  • Ear infections
  • Animal bites
  • Infected foot ulcers
  • Infected umbilical stumps in newborns born of inadequately immunized mothers

Tests and diagnosis

Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren’t helpful for diagnosing tetanus

Treatments and drugs

Since there’s no cure for tetanus, treatment consists of wound care, medications to ease symptoms and supportive care.

Wound care

Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound.

Medications

  • Your doctor may give you a tetanus antitoxin, such as tetanus immune globulin.
  • Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria.
  • Doctors generally use powerful sedatives to control muscle spasms.
  • Other drugs. Other medications, such as magnesium sulfate and certain beta blockers, may be used to help regulate involuntary muscle activity, such as your heartbeat and breathing. Morphine may be used for this purpose as well as sedation.

Supportive therapies

Tetanus infection often requires a long period of treatment in an intensive care setting. Since sedatives may result in shallow breathing, you may need to be supported temporarily by a ventilator.

Prevention

You can easily prevent tetanus by being immunized against the toxin. Almost all cases of tetanus occur in people who’ve never been immunized or who haven’t had a tetanus booster shot within the preceding 10 years.

 

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