Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- antecedent tetanus-prone injury
- tetanus immunization status
- trismus (lock jaw)
- back pain
- muscle stiffness/increased tone
- dysphagia
- spasms
Otros factores de diagnóstico
- people who inject drugs
- respiratory distress
- labile blood pressure, pulse rate, and temperature
- sweating
Factores de riesgo
- incomplete tetanus immunization
- injury
- aseptic obstetric practices
- people who inject drugs
- asterile intramuscular injection
- abdominal surgery
- acupuncture, ear piercing, pedicures, toothpicks
- necrotic tumors
- middle ear infection
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- serum toxin
- Clostridium tetani detection from wound tissue or swab
- serum antitoxin antibodies
- spores on drug samples or paraphernalia
- lumbar puncture
- electroencephalogram
- electromyogram
Algoritmo de tratamiento
clean and minor wound
tetanus-prone wound
with clinical tetanus
Colaboradores
Autores
Russell W. Steele, MD
Clinical Professor of Pediatrics
Tulane University School of Medicine
New Orleans
LA
Divulgaciones
RWS declares that he has no competing interests.
Agradecimientos
Dr Russell W. Steele would like to gratefully acknowledge Dr Christopher M. Parry, Dr Nicholas J. Beeching, Dr Lucy E. Cottle, and Professor Enitan D. Carrol, the previous contributors to this topic.
Revisores por pares
Louise Thwaites, BSc, MBBS, MD
Senior Clinical Research Fellow
Oxford University Clinical Research Unit
Hospital for Tropical Diseases
Ho Chi Minh City
Vietnam
Centre for Tropical Medicine and Global Health
Oxford University
Oxford, UK
Divulgaciones
LT is an author of a number of references cited in this topic.
Katrina Kretsinger, MD, MA
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
Divulgaciones
KK declares that she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
UK Health Security Agency. Tetanus: the green book, chapter 30. Jun 2025 [internet publication].Texto completo
Centers for Disease Control and Prevention. Child and adolescent immunization schedule by age: recommendations for ages 18 years or younger, United States, 2025. Nov 2024 [internet publication].Texto completo
Centers for Disease Control and Prevention. Adult immunization schedule by age: recommendations for ages 19 years or older, United States, 2025. Nov 2024 [internet publication].Texto completo
Havers FP, Moro PL, Hunter P, et al. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: updated recommendations of the Advisory Committee on Immunization Practices - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):77-83.Texto completo Resumen
Tiwari TSP, Moro PL, Acosta AM. Tetanus. In: Hall E, Wodi AP, Hamborsky J, et al, eds. Centers for Disease Control and Prevention. Epidemiology and vaccine-preventable diseases. 14th ed. Washington, D.C.: Public Health Foundation; 2021.Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Drug-induced dystonias, for example, phenothiazines
- Strychnine poisoning
- Neuroleptic malignant syndrome
Más DiferencialesGuías de práctica clínica
- Child and adolescent immunization schedule by age: recommendations for ages 18 years or younger, United States, 2025
- Adult immunization schedule by age: recommendations for ages 19 years or older, United States, 2025
Más Guías de práctica clínicaFolletos para el paciente
DTaP vaccine (diphtheria, tetanus, polio, and pertussis)
Más Folletos para el paciente
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