Tetanus Symptoms and Signs
The hallmark feature of tetanus is muscle rigidity and spasms. The median incubation period is seven days with a range from about four to 14 days. The shorter the incubation period, usually the more severe are the symptoms.
Figure 2: Picture of opisthotonus or arched back due to muscle spasms in a person with generalized tetanus. Source: CDC
- In generalized tetanus, the initial complaints may include any of the following:
- Irritability, muscle cramps, sore muscles, weakness, or difficulty swallowing are commonly seen.
- Facial muscles are often affected first. Trismus or lockjaw is most common. This condition results from spasms of the jaw muscles that are responsible for chewing. A sardonic smile -- medically termed risus sardonicus -- is a characteristic feature that results from facial muscle spasms.
- Muscle spasms are progressive and may include a characteristic arching of the back known as opisthotonus (Figure 2). Muscle spasms may be intense enough to cause bones to break and joints to dislocate.
- Severe cases can involve spasms of the vocal cords or muscles involved in breathing. If this happens, death is likely, unless medical help (mechanical ventilation with a respirator) is readily available.
- In cephalic tetanus, in addition to lockjaw, weakness of at least one other facial muscle occurs. In two-thirds of these cases, generalized tetanus will develop.
- In localized tetanus, muscle spasms occur at or near the site of the injury. This condition can progress to generalized tetanus.
- Neonatal tetanus is identical to generalized tetanus except that it affects the newborn infant. Neonates may be irritable and have poor sucking ability or difficulty swallowing.
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