Summary
Definition
History and exam
Key diagnostic factors
- antecedent tetanus-prone injury
- tetanus immunization 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 immunization
- injury
- aseptic obstetric practices
- injecting drug habits
- asterile intramuscular injection
- abdominal surgery
- acupuncture, ear piercing, pedicures, toothpicks
- necrotic tumors
- middle ear infection
Diagnostic investigations
Investigations to consider
- serum toxin
- Clostridium tetani detection from wound tissue or swab
- serum antitoxin antibodies
- spores on drug samples or paraphernalia
- lumbar puncture
- EEG
- EMG
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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