Prevention includes appropriate management of tetanus-prone wounds and complete active immunisation, with passive immunisation administered when required.
Diagnosis is based on clinical findings that include trismus, muscle rigidity, spasms, respiratory embarrassment, dysphagia, or autonomic dysfunction.
Management of clinical tetanus includes supportive care, wound debridement, antimicrobials, passive and active immunisation, control of muscle spasms, and management of autonomic dysfunction.
Tetanus is a life-threatening neurological syndrome characterised by tonic muscle spasms and hyperreflexia, caused by the exotoxin of Clostridium tetani, a gram-positive spore-forming obligate anaerobe.
History and exam
Lucy E. Cottle, MA, BM BCh, MRCP, DTMH
Consultant in Infectious Diseases
Leeds Teaching Hospitals NHS Trust
LEC declares that she has no competing interests.
Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H
Consultant and Emeritus Professor of Tropical and Infectious Diseases
Royal Liverpool University Hospital
Liverpool School of Tropical Medicine
NJB lectures at non-commercial meetings and conferences and publishes articles in peer-reviewed publications on the topic of tetanus. He has received sponsorship from specialist societies only to attend and speak at conferences. Views expressed in this topic 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. NJB is an author of a number of references cited in this topic.
Enitan D. Carrol, MBChB, MRCP, MRCPCH, MD, DTMH, Dip Med Sci
Professor in Paediatric Infection (Honorary Consultant)
University of Liverpool and Alder Hey Children’s NHS Foundation Trust
EDC declares that she has no competing interests.
Christopher M. Parry, BA, MB, BCh, PhD, FRCP, FRCPath, DTMH
Consultant in Medical Microbiology
Alder Hey Children’s NHS Foundation Trust
Senior Lecturer, University of Liverpool
Honorary Clinical Research Fellow, Liverpool School of Tropical Medicine
School of Tropical Medicine and Global Health
CMP is an author of a number of references cited in this topic.
Louise Thwaites, BSc, MBBS, MD
Senior Clinical Research Fellow
Oxford University Clinical Research Unit
Hospital for Tropical Diseases
Ho Chi Minh City
Centre for Tropical Medicine and Global Health
LT is an author of a number of references cited in this topic.
Katrina Kretsinger, MD, MA
U.S. Public Health Service
HIV Vaccine Team
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
KK declares that she has no competing interests.
Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2019 external link opens in a new windowMore guidelines
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