Last reviewed: November 2017
Last updated: March  2017

Summary

Definition

History and exam

Key diagnostic factors

  • antecedent tetanus-prone injury
  • tetanus immunisation status
  • trismus (lock jaw)
  • back pain
  • muscle stiffness/increased tone
  • dysphagia
  • spasms

Other diagnostic factors

  • injecting drug habits
  • respiratory distress
  • labile blood pressure, pulse rate, and temperature
  • sweating

Risk factors

  • incomplete tetanus immunisation
  • injury
  • aseptic obstetric practices
  • injecting drug habits
  • asterile intramuscular injection
  • abdominal surgery
  • acupuncture, ear piercing, pedicures, toothpicks
  • necrotic tumours
  • middle ear infection

Diagnostic investigations

Investigations to consider

  • clinical diagnosis features of tetanus
  • serum toxin
  • Clostridium tetani detection from wound tissue or swab
  • serum antitoxin antibodies
  • spores on drug samples or paraphernalia
  • lumbar puncture
  • EEG
  • EMG
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant in Infectious Diseases

Leeds University NHS Trust

St James’s Hospital

Leeds

UK

Disclosures

LEC declares that she has no competing interests.

Senior Lecturer (Honorary Consultant)

Liverpool School of Tropical Medicine and Royal Liverpool University Hospital

Liverpool

UK

Disclosures

NJB is an author of several references cited in this monograph. NJB is partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. He is affiliated with the Liverpool School of Tropical Medicine. Views expressed in this monograph are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England.

Professor in Paediatric Infection (Honorary Consultant)

University of Liverpool and Alder Hey Children’s NHS Foundation Trust

Liverpool

UK

Disclosures

EDC declares that she has no competing interests.

Consultant in Medical Microbiology

Liverpool Clinical Laboratories

Royal Liverpool University Hospital

Honorary Clinical Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Disclosures

CMP is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Specialist in Musculoskeletal Medicine

Horsham

UK (currently no institution)

Disclosures

LT is an author of a number of references cited in this monograph.

Commander

U.S. Public Health Service

Medical Epidemiologist

HIV Vaccine Team

Epidemiology Branch

Division of HIV/AIDS Prevention

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

KK declares that she has no competing interests.

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