Materiały źródłowe

• #1 Tetanus – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625

  Tetanus is a serious disease of the nervous system caused by a toxin-producing bacterium. The disease causes muscle contractions, particularly of your jaw and neck muscles. Tetanus is commonly known as lockjaw. […] The average time from infection to appearance of signs and symptoms (incubation period) is 10 days. The incubation period can range from 3 to 21 days. […] The most common type of tetanus is called generalized tetanus. Signs and symptoms begin gradually and then progressively worsen over two weeks. They usually start at the jaw and progress downward on the body. […] Signs and symptoms of generalized tetanus include: Painful muscle spasms and stiff, immovable muscles (muscle rigidity) in your jaw, Tension of muscles around your lips, sometimes producing a persistent grin, Painful spasms and rigidity in your neck muscles, Difficulty swallowing, Rigid abdominal muscles.

• #2 Tetanus – NFID

  https://www.nfid.org/infectious-disease/tetanus/

  Common initial symptoms of tetanus are a headache and muscular stiffness in the jaw (lockjaw) followed by stiffness of the neck, difficulty swallowing, hardening of abdominal muscles, spasms, sweating, and fever. Symptoms usually begin around eight days following infection, but onset may range from three days to three weeks. […] The tetanus bacteria produce a toxin, which causes severe muscle spasms, leading to locking of the jaw, making it hard to open the mouth or swallow. In severe cases, tetanus infections can lead to death by suffocation.

• #3 Clinical Overview of Tetanus | Tetanus | CDC

  https://www.cdc.gov/tetanus/hcp/clinical-overview/index.html

  Tetanus is an infection caused by C. tetani spores. In anaerobic conditions, including those within the body, the spores germinate. […] The bacteria produce very potent toxins that the blood stream and lymphatic system can disseminate throughout the body. One of these toxins, tetanospasmin (tetanus toxin), is responsible for the serious effects of tetanus. […] Tetanus toxin causes the typical clinical manifestations of tetanus by interfering with the release of neurotransmitters and blocking inhibitor impulses. This leads to unopposed muscle contraction and spasm. […] There are three clinical forms of tetanus: generalized (includes neonatal tetanus), localized, and cephalic. They present with different signs and symptoms. […] The incubation period ranges from 3 to 21 days, averaging about 8 days.

• #4 Tetanus – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/tetanus/tetanus+-+including+symptoms+treatment+and+prevention

  Symptoms include painful muscle spasms, initially of the muscles of the neck and jaw (lockjaw), and later of the muscles of the trunk. […] Tetanus is a very serious disease and is frequently fatal, particularly in infants and the elderly. It has become more common in people who use intravenous drugs. […] Diagnosis is made based on a clinical presentation. […] Treatment requires the administration of tetanus antitoxin and antibiotics. Often prolonged treatment in the intensive care unit of a hospital is necessary. […] 1 day to several months, with an average of 10 days.

• #5 Clinical Overview of Tetanus | Tetanus | CDC

  https://www.cdc.gov/tetanus/hcp/clinical-overview/index.html

  In general, the further the injury site is from the central nervous system, the longer the incubation period. A shorter incubation period is associated with more severe disease and higher chance of death. […] Symptoms usually appear from 4 to 14 days after birth, averaging about 7 days. […] The incubation period is short, usually 1 to 2 days. […] Even with modern intensive care, generalized tetanus results in death for about 1 in 10 cases. […] The risk of death from tetanus is highest among people 70 years of age or older. […] Clinical presentation of tetanus includes: Trismus (lockjaw), spasms, muscle rigidity, difficulty swallowing or breathing (caused by muscle spasms), other findings consistent with tetanus (e.g. rapid heart rate, extreme sweating).

• #6 Tetanus – Wikipedia

  https://en.wikipedia.org/wiki/Tetanus

  Generalized tetanus is the most common type of tetanus, representing about 80% of cases. The generalized form usually presents with a descending pattern. The first sign is trismus or lockjaw, then facial spasms (called risus sardonicus), followed by stiffness of the neck, difficulty in swallowing, and rigidity of pectoral and calf muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes, with the body shaped into a characteristic form called opisthotonos. Spasms continue for up to four weeks, and complete recovery may take months. […] The incubation period of tetanus may be up to several months but is usually about ten days. In general, the farther the injury site is from the central nervous system, the longer the incubation period. However, shorter incubation periods will have more severe symptoms.

• #7 The Spectrum of Clinical Characteristics and Complications of Tetanus: A Retrospective Cross-Sectional Study From a Developing Nation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8261793/

  The current retrospective study examined the clinical characteristics, progression, and outcomes of 43 patients with a confirmed tetanus infection. […] Out of the 43 patients, 42 (97.7%) developed generalized tetanus, and nonspecific symptoms reported included dysphagia (67.4%), tachycardia (67.4%), constipation (58.1%), dyspnea (41.9%), labile blood pressure (34.9%), urinary retention (30.2%), and cranial nerve involvement (4.7%). Other more tetanus-specific clinical signs that were observed included trismus (90.7%), risus sardonicus (72.1%), opisthotonos (62.8%), pain at the wound site (16.3%), and paraesthesia at the wound site, which was observed in 6.98% of the patients. […] Respiratory arrest was present in 15 out of 20 patients who expired compared to merely five out of 23 in those who were cured. Respiratory compromise and failure therefore correlate very closely with mortality rates. Aspiration pneumonia was present in 80% of the patients who expired and in 26.1% of the patients who subsequently recovered. Not surprisingly, patients who developed respiratory complications were more likely to die. Furthermore, a shorter time of onset was associated with a higher mortality likelihood (two days in those expired versus 4 days in those cured). This is likely due to the shorter time of onset for severe symptoms that consequently lead to death.

• #8 Tetanus | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/tetanus

  Complications of the disease include laryngospasm (spasm of the vocal cords) and/or spasm of the muscles of respiration, leading to interference with breathing; fractures of the spine or long bones, resulting from sustained contractions and convulsions; and hyperactivity of the autonomic nervous system, which may lead to hypertension and/or an abnormal heart rhythm. […] The case-fatality rate ranges from 10% – 90%; it is highest in infants and the elderly and varies inversely with the length of the incubation period and the availability of experienced intensive care unit personnel and resources. […] In general, shorter incubation periods are associated with more heavily contaminated wounds, more severe disease, and a worse prognosis.

• #9

  https://www.who.int/news-room/fact-sheets/detail/tetanus

  The incubation period of tetanus varies between 3 and 21 days after infection. Most cases occur within 14 days. […] Symptoms can include: jaw cramping or the inability to open the mouth, muscle spasms often in the back, abdomen and extremities, sudden painful muscle spasms often triggered by sudden noises, trouble swallowing, seizures, headache, fever and sweating, changes in blood pressure or fast heart rate. […] In neonatal tetanus, symptoms include muscle spasms, which are often preceded by the newborns inability to suck or breastfeed, and excessive crying. […] Tetanus is diagnosed on the basis of clinical features and does not require laboratory confirmation. The WHO definition of a confirmed neonatal tetanus case is an illness occurring in an infant who has the normal ability to suck and cry in the first 2 days of life, but who loses this ability between days 3 and 28 of life and becomes rigid or has spasms.

• #10 WHO EMRO | Neonatal tetanus: risk communication and community engagement guidance | Publications | Health Emergency Preparedness and Internat

  https://www.emro.who.int/cpi/publications/neonatal-tetanus-risk-communication-and-community-engagement-guidance.html

  Neonatal tetanus symptoms: a neonate with normal ability to suck and cry during the first 2 days but who, between 3 and 28 days of age, ceases to suck normally and becomes rigid or has spasms; and muscle spasms difficulty opening the mouth, facial muscle spasm, increased muscle tone and clenched hands often preceded by the newborns inability to suck or breastfeed and excessive crying. […] Symptoms commonly appear 4 to 14 days after birth, with an average onset of about 7 days.

• #11 Tetanus Clinical Information – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tetanus/hcp/clinical.html

  Tetanus appears in three forms: […] Generalized tetanus is the most common type (about 80%) of reported tetanus. The disease usually presents with a descending pattern. The first sign is trismus or lockjaw, followed by stiffness of the neck, difficulty in swallowing, and rigidity of abdominal muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes. Spasms continue for 34 weeks. Complete recovery may take months. Between 5-10% of cases are fatal. […] The diagnosis is entirely clinical and does not depend upon bacteriologic confirmation. Symptoms usually confirm the diagnosis of tetanus. […] Tetanus is characterized by the following: stiffness of jaw (also called lockjaw), stiffness of abdominal and back muscles, contraction of facial muscles, fast pulse, fever, sweating, painful muscle spasms near the wound area (if these affect the larynx or chest wall, they may cause asphyxiation), difficulty swallowing.

• #12 How Long Until My Tetanus Symptoms Appear?

  https://www.afcurgentcare.com/cedar-hills-mill/blog/how-long-until-my-tetanus-symptoms-appear/

  Come to find out you have early signs of tetanus, otherwise known as lockjaw a rare but life-threatening disease of the nervous system. Tetanus symptoms work their way down the body, beginning in the jaw, and generally dont show up until 10 days have passed since the root of infection. […] Generalized tetanus is the most common type, making up about 80% of cases. It usually starts with muscle spasms that move down the body. The first signs are lockjaw and a stiff smile due to tight facial muscles. This can lead to a stiff neck, trouble swallowing, and tight chest and calf muscles. These spasms can last up to 4 weeks, and full recovery can take months. […] Localized tetanus is characterized by muscle spasms and rigidity confined to the area of injury where the tetanus bacteria entered the body. Symptoms are typically limited to the muscles near the infection site and can cause significant discomfort and pain.

• #13 Tetanus (Lockjaw) Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23582-tetanus-lockjaw

  Early signs of a tetanus infection include headache and muscle spasms in your jaw. Tetanus is often called lockjaw because one of the early symptoms of the condition includes jaw cramping. Your jaw muscles may tighten. This makes it difficult to open your mouth. […] Other symptoms may include: Difficulty swallowing or breathing. Drooling. Neck muscle stiffness. Muscle spasms in your stomach, back, arms and legs. Seizures. Fever and sweating. High blood pressure. Fast heart rate (tachycardia). Uncontrolled peeing (urination) and pooping (defecation). […] If you have a tetanus infection, your muscles spasm or tighten. Your facial muscles may lock into a rigid smile. Your back may arch uncontrollably. […] The incubation period for tetanus is typically between three and 21 days. The illness usually occurs within 14 days of exposure. But the range varies widely based on what kind of wound you have. Illness may develop within a day or it could take months.

• #14 About Tetanus | Tetanus | CDC

  https://www.cdc.gov/tetanus/about/index.html

  Symptoms typically occur between 3 and 21 days (average 8 days) after someone is exposed to C. tetani. […] The first sign is most commonly spasms of the jaw muscles, or „lockjaw.” […] Other symptoms can include: Trouble swallowing, Sudden, involuntary muscle spams often in the stomach, Painful muscle stiffness all over the body, Seizures (jerking or staring), Headache, Fever and sweating, Changes in blood pressure and heart rate. […] Tetanus requires immediate treatment. Contact your healthcare provider if you have tetanus symptoms. […] Tetanus can lead to death (1 in 10 cases in the United States are fatal). […] Healthcare providers usually decide if someone has tetanus by looking for common signs and symptoms. They may also ask about a recent history of cuts, scrapes, punctures, and trauma.

• #15 Tetanus – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/tetanus

  Tetanus is acute poisoning resulting from a neurotoxin produced by Clostridium tetani. Symptoms are intermittent tonic spasms of voluntary muscles. Spasm of the masseters accounts for the name lockjaw. […] Symptoms of tetanus include jaw stiffness (most frequent), difficulty swallowing, restlessness, irritability, stiff neck, arms, or legs, arching of the back (opisthotonos), headache, sore throat, and tonic spasms. Later, patients have difficulty opening their jaw (trismus). […] Characteristic painful, generalized tonic spasms with profuse sweating are precipitated by minor disturbances such as a draft, noise, or movement. Mental status is usually clear, but coma may follow repeated spasms. During generalized spasms, patients are unable to speak or cry out because of chest wall rigidity or glottal spasm. Rarely, fractures result from sustained spasms.

• #16 Tetanus Symptoms and Treatment | Mass General Brigham

  https://www.massgeneralbrigham.org/en/about/newsroom/articles/tetanus-symptoms-and-treatment

  Tetanus is a sometimes fatal disease of the central nervous system, which is the brain and spinal cord, explains Ellen Nagami, MD, MPH. […] Once inside the body, the tetanus bacteria make a poison that causes painful and uncontrollable muscle spasms or contractions. Tetanus can also be called lockjaw, because of the effect is has on the body. […] Symptoms for tetanus often dont show up right away. It may take 3 to 21 days to develop symptoms. On average, symptoms appear around day 8, Dr. Nagami says. In infants, symptoms can develop from 3 days to 2 weeks. […] The most common signs and symptoms of tetanus are: Stiff abdominal and back muscles, Contraction of the facial muscles, Painful muscle spasms, especially near the wound area, Fever, Fast pulse, Trouble swallowing, Difficulty breathing. […] A tetanus infection is a medical emergency that requires hospital care. With severe symptoms, patients may not be able to breathe on their own. If youre having trouble swallowing, difficulty breathing, or are concerned you may have tetanus, call 9-1-1 or go to an emergency room.

• #17 Tetanus Symptoms

  https://www.webmd.com/brain/understanding-tetanus-symptoms

  Tetanus, a potentially deadly bacterial infection, is rare in the United States thanks to vaccination. But it can happen, so it’s important to know tetanus disease symptoms so you can get treatment quickly. […] The first signs of generalized tetanus are often painful spasms — movements you can’t control — in your jaw. Tetanus symptoms set in an average of 10 days after the bacteria get into your body. But they can start as soon as three days after infection or after three weeks or more. […] As the disease progresses, you may get painful spasms that look like seizures that effect much of your body. Your neck and back may arch as your legs stiffen and your arms curl toward your body. Stiff muscles in your neck and abdomen might make it hard for you to breathe. These spasms can be so severe that they tear muscles or break bones in your spine.

• #18 Tetanus Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/229594-clinical

  Most cases of tetanus in the United States occur in patients with a history of underimmunization, either because they were never vaccinated or because they completed a primary series but have not had a booster in the preceding 10 years. […] The incubation period can vary between 1-21 days with the majority of cases developing within 8 days. Cases with faster incubation are generally more severe in nature. […] Patients may report a sore throat with dysphagia (early sign). The initial manifestation may be local tetanus, in which the rigidity affects only 1 limb or area of the body where the clostridium-containing wound is located. Trismus (ie, lockjaw) is commonly the first presenting symptom. Other presenting complaints include stiffness, neck rigidity, restlessness, and reflex spasms. […] Subsequently, muscle rigidity becomes the major manifestation. Muscle rigidity spreads in a descending pattern from the jaw and facial muscles over the next 24-48 hours to the extensor muscles of the limbs.

• #19 Tetanus – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625

  Progression of tetanus results in repeated painful, seizure-like spasms that last for several minutes (generalized spasms). Usually, the neck and back arch, the legs become rigid, the arms are drawn up to the body, and the fists are clenched. Muscle rigidity in the neck and abdomen may cause breathing difficulties. […] As the disease progresses, other signs and symptoms may include: High blood pressure, Low blood pressure, Rapid heart rate, Fever, Extreme sweating. […] This uncommon form of tetanus results in muscles spasms near the site of a wound. While it’s usually a less severe form of disease, it can progress to generalized tetanus. […] This rare form of tetanus results from a head wound. It results in weakened muscles in the face and spasms of the jaw muscles. It also can progress to generalized tetanus.

• #20 Tetanus – Wikipedia

  https://en.wikipedia.org/wiki/Tetanus

  Tetanus is a bacterial infection caused by Clostridium tetani and characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually lasts for a few minutes. Spasms occur frequently for three to four weeks. Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. The onset of symptoms is typically 3 to 21 days following infection. Recovery may take months; about 10% of cases prove to be fatal. […] Tetanus often begins with mild spasms in the jaw muscles also known as lockjaw. Similar spasms can also affect the facial muscles, resulting in an appearance called risus sardonicus. Chest, neck, back, abdominal muscles, and buttocks may be affected. Back muscle spasms often cause arching, called opisthotonus. Sometimes, the spasms affect muscles utilized during inhalation and exhalation, which can lead to breathing problems.

• #21 Tetanus: symptoms, treatment and vaccination – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/tetanus-symptoms-treatment-and-vaccination

  Tetanus is caused by a neurotoxin produced by the bacterium Clostridium tetani. The disease is characterised by muscle contractions of the jaw and neck, including generalised muscle spasms. Although it is now rare in the developed world, tetanus can be fatal without appropriate and timely access to medical care. […] Tetanus can affect people of all ages; however, the highest incidence in the UK is in adults aged over 64 years because they are more likely to be inadequately vaccinated. Newborn babies and mothers who have not been vaccinated, as well as people who inject drugs, are also at a higher risk of tetanus. […] There are three main clinical presentations of tetanus: Generalised tetanus, Local tetanus, and Cephalic tetanus. […] This is the most common and severe clinical form of tetanus and is characterised by trismus (lockjaw), muscle rigidity and painful muscle spasms. During generalised tetanic spasms, patients characteristically clench their fists, arch their back, and flex and abduct their arms while extending their legs. Continual spasms and rigidity can lead to breathing difficulties.

• #22 Tetanus Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/229594-clinical

  Dysphagia occurs in moderately severe tetanus as a consequence of pharyngeal muscle spasms, and onset usually is insidious over several days. Reflex spasms develop in most patients and can be triggered by minimal external stimuli such as noise, light, or touch. The spasms last seconds to minutes; become more intense; increase in frequency with disease progression; and can cause apnea, fractures, dislocations, and rhabdomyolysis. Laryngeal spasms can occur at any time and can result in asphyxia. […] Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. […] Sustained contraction of facial musculature produces a sneering grin expression known as risus sardonicus. […] Generalized tetanus is the most commonly found form of tetanus in the United States, accounting for about 80% of cases. The extent of the trauma varies from trivial injury to contaminated crush injury. The incubation period is 8 days on average, largely depending on the distance of the injury site from the central nervous system (CNS). Spasms can occur for 3-4 weeks with total recovery often requiring months.

• #23 Tetanus | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/tetanus

  Complications of the disease include laryngospasm (spasm of the vocal cords) and/or spasm of the muscles of respiration, leading to interference with breathing; fractures of the spine or long bones, resulting from sustained contractions and convulsions; and hyperactivity of the autonomic nervous system, which may lead to hypertension and/or an abnormal heart rhythm. […] The case-fatality rate ranges from 10% – 90%; it is highest in infants and the elderly and varies inversely with the length of the incubation period and the availability of experienced intensive care unit personnel and resources. […] In general, shorter incubation periods are associated with more heavily contaminated wounds, more severe disease, and a worse prognosis.

• #24 Tetanus (lockjaw)

  https://www.health.ny.gov/diseases/communicable/tetanus/fact_sheet.htm

  Tetanus, commonly called lockjaw, is a serious bacterial disease that affects muscles and nerves. It is characterized by muscle stiffness that usually involves the jaw and neck that then progresses to involve other parts of the body. Death can result from severe breathing difficulties or heart abnormalities. […] A common first sign of tetanus is muscular stiffness in the jaw (lockjaw). Other symptoms include stiffness of the neck, trouble swallowing, painful muscle stiffness all over the body, spasms, sweating, and fever. […] The incubation period is usually 8 days but may range from 3 days to 3 weeks. Shorter incubation periods are associated with more heavily contaminated wounds. […] Complications include spasm of the vocal cords and/or spasms of the respiratory muscles causing interference with breathing. Other complications include fractures of the spine or long bones from stiff muscles, elevated blood pressure, abnormal heartbeats, coma, clotting in the blood vessels of the lung, and pneumonia. Even with modern intensive care, tetanus is associated with death rates of 10-20%.

• #25 Tetanus prone wounds

  https://www.rch.org.au/kidsinfo/fact_sheets/Tetanus_prone_wounds/

  Tetanus (sometimes called lock-jaw) is a disease caused by bacteria (Clostridium tetani) often found in soil. The disease usually occurs after an incubation period of three to 21 days, but ranges from one day to several months. Early symptoms of tetanus include: painful muscle spasms that begin in the jaw (lock jaw); stiff neck, shoulder and back muscles; difficulty swallowing; violent generalised muscle spasms; convulsions; and breathing difficulties. […] A person may have a fever and sometimes develop abnormal heart rhythms. Complications include pneumonia, broken bones (from the muscle spasms), respiratory failure and cardiac arrest.

• #26 Tetanus: Symptoms, Shot, Prevention, Treatment, and More

  https://www.verywellhealth.com/tetanus-overview-4165512

  The spasms can also close off breathing passages, resulting in the shortness of breath, choking, and periods when there is no breathing at all. The episodes are often triggered by minor stimuli, such as a sudden draft, loud noise, bright light, or even a light touch. […] In severe cases, sympathetic overactivity (SOA) will occur in which sympathetic nerves, which govern involuntary body responses, are hyperstimulated, triggering the spasmodic constriction of blood vessels. Symptoms of SOA include: […] In combination with tetanus-induced spasms, SOA can trigger life-threatening complications including pulmonary embolism (blood clot in the lungs) and heart attack. Respiratory failure is the most common cause of death. […] Even with comprehensive treatment, 10% of tetanus infections will result in death.

• #27 Disease factsheet about tetanus

  https://www.ecdc.europa.eu/en/tetanus/facts

  There are three clinical presentations of tetanus: generalized tetanus, which is the most common form; localised tetanus; and cephalic tetanus. […] In generalized tetanus, the presenting symptoms include trismus (lock jaw), episthotonus, facial grimacing (risus sardonicus), spasms, back and neck stiffness, muscle rigidity, dysphagia, and restlessness. Reflex spasms are triggered by minor external stimuli such as noise, light or touch. […] Tetanus neonatorum is a generalised form of tetanus in newborns. Contamination of the cord stump with C. tetani spores occurs as a result of unclean delivery and cord care practices. Newborns of unimmunised mothers lack passive protection from maternal antibodies to the tetanus toxin and are at high risk. The typical case is a previously well and feeding newborn who presents at age 3-14 days with symptoms of irritability, inability to suck, muscle rigidity, facial grimacing, opisthotonos and severe spasms elicited by sound, light and sensory stimuli.

• #28 Tetanus – What You Need to Know

  https://www.drugs.com/cg/tetanus.html

  You may have stiff and weak muscles only in the area of the wound. This is called localized tetanus. Symptoms may go away without treatment, or they may spread. Infection that spreads is called generalized. You may develop any of the following within days or weeks of the infection: […] Lockjaw (a muscle spasm in the jaw and neck that locks your jaw closed) […] Muscle spasms that are severely painful, often triggered by noise, light, or touch […] Rigid facial muscles, or raised eyebrows with lips pulled into a grin […] Rigid abdomen, arm, and leg muscles […] Trouble breathing or swallowing […] Feeling restless or irritable, or a fast heartbeat or breathing […] A headache or seizures […] Sweating, trouble urinating, or a low fever.

• #29 Tetanus Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/229594-clinical

  Trismus is the presenting symptom in 75% of cases; a dentist or an oral surgeon often initially sees the patient. Other early features include irritability, restlessness, diaphoresis, and dysphagia with hydrophobia, drooling, and spasm of the back muscles. These early manifestations reflect involvement of bulbar and paraspinal muscles, possibly because these structures are innervated by the shortest axons. The condition may progress for 2 weeks despite antitoxin therapy because of the time needed for intra-axonal antitoxin transport. […] In mild cases of localized tetanus, patients may have weakness of the involved extremity, presumably due to partial immunity; in more severe cases, they may have intense, painful spasms of the group of muscles in close proximity to the site of injury. This disorder may persist for several weeks but is usually self-limiting; however, more severe cases tend to progress to generalized tetanus.

• #30 Tetanus – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/tetanus

  In localized tetanus, there is spasticity of muscles near the entry wound but no trismus; spasticity may persist for weeks. […] Tetanus in neonates is usually generalized and frequently fatal. It often begins in an inadequately cleansed umbilical stump in children born of inadequately immunized mothers. Onset during the first 2 weeks of life is characterized by rigidity, spasms, and poor feeding. Bilateral deafness may occur in surviving children.

• #31 Tetanus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/229594-overview

  Patients with localized tetanus present with persistent rigidity in the muscle group close to the injury site. […] Cephalic tetanus is uncommon and usually occurs after head trauma or otitis media. Patients with this form present with cranial nerve (CN) palsies. The infection may be localized or may become generalized. […] Neonatal tetanus (tetanus neonatorum) is a major cause of infant mortality in underdeveloped countries but is rare in the United States. Infection results from umbilical cord contamination during unsanitary delivery, coupled with a lack of maternal immunization. At the end of the first week of life, infected infants become irritable, feed poorly, and develop rigidity with spasms. Neonatal tetanus has a very poor prognosis. […] Although tetanus is quite rare, early diagnosis and intervention are lifesaving.

• #32 How Long Until My Tetanus Symptoms Appear?

  https://www.afcurgentcare.com/cedar-hills-mill/blog/how-long-until-my-tetanus-symptoms-appear/

  Cephalic or cerebral tetanus affects the muscles and nerves of the head. It usually occurs after head injuries such as skull fractures, cuts on the head, eye injuries, dental work, or ear infections. Symptoms include stiff neck, trouble swallowing, lockjaw, retracted eyelids, eyes that don’t align properly, and rigid smile. These symptoms can lead to serious issues like choking on food, paralysis of breathing and throat muscles, and respiratory failure. This type of tetanus can also spread to the whole body.

• #33 Tetanus Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/229594-clinical

  Cephalic tetanus is characterized by variable CN palsies. Noticeable symptoms on physical exam may include neck stiffness, deviation of the eyes, risus sardonicus, or retraction of the eyelids. Patients also may present with symptoms of generalized tetanus. […] Neonatal tetanus presents with physical exam findings similar to generalized tetanus. Newborns may present with poor ability to suck or breastfeed, generalized spasms, or crying.

• #34 Tetanus: symptoms, treatment and vaccination – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/tetanus-symptoms-treatment-and-vaccination

  Other severe symptoms include autonomic instability (i.e. when the autonomic nervous system does not function correctly), resulting in tachycardia, hypertension and sweating (sometimes rapidly alternating with bradycardia and hypotension). […] Presents with tonic and spastic muscle contractions in one extremity or body region, usually in the same area as the injury site. Local tetanus often, but not invariably, progresses to generalised tetanus. […] This is a rarer form of the disease. Patients with injuries to the head or neck may present with cephalic tetanus, which initially involves only cranial nerves. The facial nerve is most commonly affected, but involvement of other cranial nerves may also occur. Patients may manifest confusing clinical findings including dysphagia, trismus and focal cranial neuropathies that can lead to a misdiagnosis of stroke. Like other forms of local tetanus, patients with cephalic tetanus can progress to generalised tetanus.

• #35 Tetanus – UpToDate

  https://www.uptodate.com/contents/tetanus/print

  Tetanus is a nervous system disorder characterized by muscle spasms that is caused by the toxin-producing anaerobe Clostridium tetani, which is found in the soil. The most common and severe clinical form of tetanus is generalized tetanus. The presenting symptom in more than 80 percent of such patients is trismus (lockjaw), although patients with generalized tetanus sometimes present initially with cephalic or localized tetanus. Patients with generalized tetanus typically have symptoms of autonomic overactivity that may manifest in the early phases as sweating and tachycardia. In later phases of illness, profuse sweating, cardiac arrhythmias, labile hypertension or hypotension, and fever are often present. Patients with generalized tetanus characteristically have tonic contraction of their skeletal muscles and intermittent intense muscular spasms. Since patients with tetanus have no impairment of consciousness or awareness, both the tonic contractions and spasms are intensely painful. Tetanus toxin-induced effects are long lasting because recovery is believed to require the growth of new axonal nerve terminals. The usual duration of clinical tetanus is four to six weeks. The severity and frequency of the clinical features of tetanus may vary from case to case, depending upon the amount of tetanus toxin that reaches the central nervous system. Symptoms and signs may progress for up to two weeks after the disease onset. The severity is related to the incubation period of the illness and the interval from the onset of symptoms to the appearance of spasms; the longer the interval, the milder the clinical features of tetanus. More severe illness is seen in those with deep penetrating wounds. Neonatal tetanus typically occurs in infants 5 to 7 days following birth (range 3 to 24 days). The onset of illness is typically more rapid in neonatal tetanus than in older individuals and may progress over hours rather than days, probably because axonal length is proportionately shorter in infants. Neonatal tetanus presents with refusal to feed and difficulty opening the mouth due to trismus in an infant previously able to feed and cry normally. Sucking then stops and facial muscles spasm, which may result in risus sardonicus (sardonic smile). The hands are often clenched, the feet become dorsiflexed, and muscle tone increases. As the disease progresses, neonates become rigid and opisthotonus (spasm of spinal extensors) develops.

• #36 Tetanus – Harvard Health

  https://www.health.harvard.edu/a_to_z/tetanus-a-to-z

  On average, symptoms of tetanus begin seven to eight days after tetanus bacteria enter the body. These symptoms may include: […] Spasms in the jaw muscles produce lockjaw. Spasms also occur in muscles of the throat, chest, abdomen and extremities. If you don’t receive proper treatment, the toxin’s effect on respiratory muscles can interfere with breathing. If this happens, you may die of suffocation. […] Severe muscle spasms may last for about three to four weeks and then slowly get better. Once these spasms subside, recovery takes several months. […] Most patients with tetanus survive and return to previous function. Older people and those who have a rapid progression from time of infection to severe symptoms have a higher risk of death.

• #37 Tetanus (Lockjaw) Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23582-tetanus-lockjaw

  Once tetanus symptoms develop, it can take two to three weeks for the disease to run its course. With proper treatment, most people recover. But it can take several months to fully recover from tetanus. […] If tetanus symptoms have developed, the disease has to run its course. This can take several weeks. With proper treatment, most people recover. But it can take several months to fully recover. […] Worldwide, one in four people infected with tetanus will die without treatment. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 15% of infected people die. In the U.S., tetanus is rarely fatal with proper treatment.

• #38 Tetanus

  https://www.nhs.uk/conditions/tetanus/

  The symptoms of tetanus usually start around 4 to 21 days after infection. Most people get symptoms after about 10 days. […] The symptoms of tetanus include: a stiff jaw (lockjaw), which can make opening your mouth difficult; painful muscle spasms, often in your back, tummy, arms, legs, hands and feet; difficulty breathing; swallowing problems; a high temperature; sweating; a fast heartbeat; fits (seizures). […] Tetanus is a medical emergency that needs to be treated immediately in hospital. […] It can take several weeks or sometimes months to fully recover from tetanus.

• #39 Tetanus – Immunisation

  https://www.hse.ie/eng/health/immunisation/pubinfo/pcischedule/vpds/tetanus/

  Generalised symptoms occur in 80 % of cases. The first symptom is severe muscle spasm felt in the neck and jaw muscles (Lockjaw). This may be followed by painful muscle spasms in the back, abdomen and limbs. Fractures can be caused by the violent contractions. Difficulty in breathing and swallowing can develop. A spasm of part of the voice box can cause immediate death. The disease remains severe for 1 to 4 weeks, and then gradually subsides. Death may occur in 10%- 25% of cases. […] Tetanus is a very serious disease. The risk is greatest for the very young or aged over 60. In infants tetanus can lead to permanent brain damage because of loss of oxygen. Fractures of limbs and spine can lead to permanent disability. Of the people who get tetanus 1 in 10 will die. The severe muscles spasms interfere with breathing.

• #40 Tetanus: infection, symptoms, treatment | gesund.bund.de

  https://gesund.bund.de/en/tetanus

  In the further course of the disease, the toxins of the tetanus bacteria also attack the nerves supplying the respiratory organs and blood vessels. The patients then have difficulty breathing, fluctuations in blood pressure and sweating. Fatalities are often the result of lung and cardiovascular failure. […] The localized form sometimes occurs if people are only partially immune. This can be the case, for example, if they were vaccinated a long time ago. The symptoms are then limited to the muscles in the immediate vicinity of the wound. This form of tetanus is usually harmless but can develop into the generalized form. […] The newborn form can occur if a mother is not vaccinated and the infant’s umbilical stump is not kept hygienically clean. In infants, the tetanus pathogens enter the body through the umbilical stump. If an infection occurs when the umbilical cord is cut, newborns exhibit symptoms within the first two weeks of their life. These include muscle stiffness, spasms and sucking weakness.

• #41 What Is Tetanus? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/tetanus/guide/

  Symptoms, including spasms, can last for several minutes at a time and continue for three to four weeks or longer. Complete recovery from the disease may take months. […] The prognosis generally depends on incubation period and the time from first symptom to first muscle spasm. In general, if symptoms develop and progress rapidly, the prognosis is worse. But with treatment, patients usually survive tetanus and recover. […] Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. The lack of oxygen induces cardiac arrest and death. Pneumonia is another cause of death.

• #42 Disease factsheet about tetanus

  https://www.ecdc.europa.eu/en/tetanus/facts

  Localised tetanus is an uncommon presentation localised to the site of spore entry, with weakness of the involved extremity and intense, painful spasms in severe cases. […] Cephalic tetanus is the result of inoculation by way of head injury or middle ear infection and presents as motor cranial nerve palsies commonly affecting the facial nerve. […] There is a direct relationship between the distance from the inoculation wound to the central nervous system and the onset of symptoms. […] The clinical course of generalised tetanus is variable and reported case fatality ratios for hospitalised cases range from 20-70%. Short incubation and early manifestations of autonomic dysfunction, young age, and old age are associated with more severe disease and higher case fatality. […] Sequelae of neonatal tetanus: Studies have linked neonatal tetanus to neurological disabilities ranging from cerebral palsy and severe psychomotor retardation to subtle intellectual and behavioural abnormalities but it has not been established how much is caused by the neurotoxin and how much is the result of compromised respiration and hypoxia.

• #43 Immunizations: Tetanus (Lockjaw) | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/immunization/tetanus.htm

  Tetanus can be deadly, especially in older people and those who arent vaccinated. […] The time it takes from the bacteria entering your body until you feel sick is called the incubation period. For tetanus, the incubation period is usually between three and 21 days. Most people get tetanus symptoms 14 days after exposure. How long it takes depends on the type of wound. People get tetanus symptoms sooner after dirtier or more serious wounds. […] Early symptoms may include: Headache. Fever. Spasms of the jaw muscle (also called lockjaw). […] Other symptoms can develop, such as: Stiffness in the neck and jaw. Difficulty swallowing. Painful muscle spasms. Changes in blood pressure and heart rate. Jerking or staring (seizures). […] Tetanus can lead to serious health problems. These may include: Being unable to open your mouth. Having trouble swallowing and breathing. Broken bones (fractures). Uncontrolled, or involuntary, tightening of the vocal cords (laryngospasm). Lung infection that develops by breathing in foreign materials (aspiration pneumonia). Blot clot blocking blood flow in the lung (pulmonary embolism). […] Out of every 10 people who get tetanus, one to two of them die.

• #44 About Tetanus | Tetanus | CDC

  https://www.cdc.gov/tetanus/about/index.html

  Tetanus is a medical emergency requiring: Evaluation and care in the hospital, Immediate treatment with TIG, Aggressive wound care, Drugs to control muscle spasms, Antibiotics, Tetanus vaccination. […] Depending on how serious the infection is, someone with tetanus may need a machine to help them breathe.

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