Exams and Tests

The diagnosis of generalized tetanus is usually made by observing the clinical presentation and a combination of the following:

• history of a recent injury resulting in skin breakage (but this is not universal; only 70% of cases have an identified injury);



• incomplete tetanus immunizations;



• progressive muscle spasms (starting in the facial region, especially lockjaw and progressing outward from the face to include all muscles of the body);



• fever;



• changes in blood pressure (especially high blood pressure);



• irregular heartbeat;



• in localized tetanus, pain, cramps, or muscle spasms occur at or near a recent skin injury;



• neonates show signs of being generally irritable, muscle spasms, and poor ability to take in liquids (poor sucking response), usually seen in neonates about 7-10 days old; and



• laboratory tests: Though rarely used, some reference labs can determine if the patient has serum antitoxin levels that are protective, and thus a positive test suggests that the diagnosis of tetanus is unlikely.