Tetanus: Symptoms, causes, and treatments

Tetanus, also called lockjaw, is a serious infection caused by Clostridium tetani. This bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles.

If Clostridium tetani spores are deposited in a wound, the neurotoxin interferes with nerves that control muscle movement.

The infection can cause severe muscle spasms, serious breathing difficulties, and can ultimately be fatal.
Although tetanus treatment exists, it is not uniformly effective. The best way to protect against tetanus is to take the vaccine.

Fast facts on tetanus

Here are some key points about tetanus. More detail and supporting information is in the main article.

Tetanus is caused by the Clostridium tetani bacterium

The early symptoms of tetanus include diarrhea, fever, and headache

Earlier diagnosis predicts better outcomes

What is tetanus?

Tetanus vaccine
Tetanus can be fatal but vaccinations are standard in the U.S.

Tetanus is a serious bacterial infection.

The bacteria exist in soil, manure, and other environmental agents. A person who experiences a puncture wound with a contaminated object can develop the infection, which can affect the whole body. It can be fatal.

In the United States, there are about 30 cases a year. These are mostly people who have not been vaccinated against tetanus or who have not kept up their booster shots every 10 years.

Tetanus is a medical emergency. It will need aggressive wound treatment and antibiotics.


Tetanus symptoms usually emerge about 7 to 10 days after initial infection. However, this can vary from 4 days to about 3 weeks, and may, in some cases, may take months.

In general, the further the injury site is from the central nervous system, the longer the incubation period. Patients with shorter incubation times tend to have more severe symptoms.

Muscle symptoms include spasms and stiffness. Stiffness usually starts with the chewing muscles, hence the name lockjaw.

Muscle spasms then spread to the neck and throat, causing difficulties with swallowing. Patients often have spasms in their facial muscles.

Breathing difficulties may result from neck and chest muscle stiffness. In some people, abdominal and limb muscles are also affected.

In severe cases, the spine will arch backward as the back muscles become affected. This is more common when children experience a tetanus infection.

Most individuals with tetanus will also have the following symptoms:

bloody stools




sensitivity to touch

sore throat


rapid heartbeat

[Wound on the knee being treated]
Wounds should be thoroughly cleaned to prevent infection.

Any cut or wound must be thoroughly cleaned to prevent infection. A tetanus-prone wound should be treated by a medical professional immediately.

A wound likely to develop tetanus is defined as:

a wound or burn that requires surgical intervention that is delayed for over 6 hours

a wound or burn that has a considerable amount of removed tissue

any puncture-type injury that has been in contact with manure or soil

serious fractures where the bone is exposed to infection, such as compound fractures

wounds or burns in patients with systemic sepsis

Any patient with a wound listed above should receive tetanus immunoglobulin (TIG) as soon as possible, even if they have been vaccinated. Tetanus immunoglobulin contains antibodies that kill Clostridium tetani. It is injected into a vein and provides immediate short-term protection against tetanus.

TIG is just short-term and does not replace the long-term effects of vaccination. Experts say that TIG injections can be safely administered to pregnant and breastfeeding mothers.

Doctors may prescribe penicillin or metronidazole for tetanus treatment. These antibiotics prevent the bacterium from multiplying and producing the neurotoxin that causes muscle spasms and stiffness.

Patients who are allergic to penicillin or metronidazole may be given tetracycline instead.

In treating muscle spasms and stiffness, patients may be prescribed:

Anticonvulsants, such as diazepam (Valium), relax the muscles to prevent spasms, reduce anxiety, and work as a sedative.

Muscle relaxants, such as baclofen, suppress nerve signals from the brain to the spinal cord, resulting in less muscle tension.

Neuromuscular blocking agentsblock the signals from nerves to muscle fibers and are useful in controlling muscle spasms. They include pancuronium and vecuronium.


If the doctor thinks the tetanus prone wound is very large, they may surgically remove as much of the damaged and infected muscle as possible (debridement).

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