Tetanus: Symptoms, Causes & Treatment

Tetanus is a serious infection caused by the bacterium Clostridium tetani. The bacteria can be found in soil, dust, and animal feces.

Tetanus usually develops when C. tetani spores enter the body through a cut, puncture wound, burn, or other break in the skin. The bacteria then produce a toxin that can cause symptoms such as muscle spasms, fever, and muscle stiffness.

If symptoms of tetanus develop, it is important to seek medical care immediately. Tetanus is a medical emergency that requires prompt treatment in a hospital.

Tetanus symptoms

The main symptoms of tetanus are:

• Muscle spasms

• Stiff neck muscles

• Fever

• Lockjaw

• Stiff, painful abdominal muscles

• Severe muscle pain

• Difficulty opening the mouth or swallowing

• Headache

Tetanus symptoms usually develop between 2 and 28 days after exposure to Clostridium tetani. Other symptoms may include excessive sweating, arching of the back, a rapid heartbeat, and seizures.

If tetanus is not diagnosed and treated, it can affect more muscles throughout the body. When the muscles involved in breathing are affected, tetanus can lead to respiratory failure and become life-threatening.

Confirming a diagnosis

Tetanus is diagnosed by a healthcare professional based on the signs and symptoms present, along with the person's medical history, vaccination history, and any recent wounds or injuries.

According to the CDC, there are no diagnostic tests that can confirm or rule out tetanus. Tests may sometimes be ordered to evaluate complications or rule out other conditions that could be causing the symptoms.

What causes tetanus

Some factors that can increase the risk of tetanus include:

• Puncture wounds caused by objects such as nails or needles
• Injuries involving dead or damaged tissue
• Animal scratches or bites
• Burns
• Tattoos and piercings performed with contaminated equipment
• Wounds contaminated with dirt, saliva, or animal feces
• Chronic skin wounds or infections
• Diabetic foot ulcers
• Gunshot wounds
• Septic abortion or uterine infection following a contaminated abortion procedure

More rarely, tetanus can develop after superficial wounds, surgical procedures, contaminated insect bites, dental infections, ear infections, open fractures, sharing needles during injection drug use, or contaminated injections.

Newborns can also develop neonatal tetanus if the mother has not been adequately vaccinated and the umbilical cord is cut or cared for using contaminated or nonsterile instruments or materials containing Clostridium tetani spores.

Treatment options

Treatment should begin as soon as possible to reduce the risk of complications. Tetanus is a medical emergency and generally requires hospitalization.

Treatment may include tetanus immune globulin (TIG), which helps neutralize toxin that has not yet attached to nerve tissue. Antibiotics, medications to control muscle spasms, wound cleaning, and a tetanus vaccine (tetanus shot) may also be used.

People with severe tetanus may need mechanical ventilation to help them breathe.

Possible complications

Possible complications of tetanus include:

• Vocal cord paralysis
• Respiratory failure
• Aspiration pneumonia
• High blood pressure
• Bone fractures
• Urinary retention
• Asphyxia
• Coma

These complications can result from severe muscle contractions and the effects of tetanus toxin on the nervous system.

Prompt treatment is essential because some complications can be life-threatening.

Prevention measures

The main way to prevent tetanus is through vaccination.

According to the CDC, children should receive a 5-dose DTaP series at 2, 4, and 6 months, 15 to 18 months, and 4 to 6 years, while adolescents should receive one Tdap dose at 11 to 12 years and adults should receive a Td or Tdap booster every 10 years.

A tetanus-containing vaccine may also be recommended after certain wounds, depending on the injury and vaccination history. Tetanus immune globulin may be needed for some people who are not fully vaccinated or whose vaccination history is unknown.

Proper wound care also helps prevent tetanus. Wounds should be cleaned promptly, and medical care should be sought for deep puncture wounds, contaminated wounds, or injuries involving dead tissue.

Avoid sharing needles or other contaminated sharp objects.