Tetanus history and symptoms: Difference between revisions
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Revision as of 18:56, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. A history of puncture wounds, burns, scratches by animals, fractures, and surgical wounds in a patient presenting with symptoms of tetanus may be indicative of a tetanus infection. Trismus, or lockjaw, spasms of the facial muscles (risus sardonicus), neck stiffness and swallowing difficulty are common symptoms of tetanus.[1][2]Common iatrogenic sources of infection that may be revealed in a patient's history include recent surgeries on the gastrointestinal tract or abortions. History of recent accident or an injury leading to a break in the continuity of the skin in a contaminated environment is helpful in making a diagnosis.
History and Symptoms
Tetanus infection is a clinical diagnosis that must be suspected in patients with:
- An injury involving contact of broken skin with contaminated environment, soil or dust.
- An absent or inconsistent history of immunizations.
The history of a patient presenting with tetanus typically reveals soil, rust containing metal or manure related contamination of an injury or a wound. Punctured wounds, burns, scratches by animals, fractures, otitis media and surgical wounds that are contaminated, these can be related to surgeries on the gastrointestinal tract or abortions. Contamination of the umbilical cord may also be an important history finding.[3][4][5]
- Punctured wounds
- Burns
- Scratches by animals
- Fractures
- Otitis media
- Surgical wounds that are contaminated
- Gastrointestinal tract surgeries
- Abortion
- Contamination of the umbilical cord
- Unhygienic clamping
- Covering with juice or cow dung
Local Tetanus
- Localized injury
- Contaminated wound
- Spasmodic contraction limited to area of injury
- May continue for weeks
- Can lead to features of generalized tetanus
Cephalic Tetanus
- Rare
- Associated with otitis media (ear infections with C. tetani present in the middle ear), or after head injuries
- Cranial nerve involved specially facial area
Generalized Tetanus
- Descending muscle spasm
- The first sign is trismus or lockjaw. It can be followed by
- Neck stiffness
- Swallowing difficulty
- Stiffening of the calf and pectoral muscle groups
- Some other symptoms of tetanus may include:
- Temperature elevation
- Sweating
- Blood pressure elevation
- Episodes of tachycardia
- Episodic spasms (for minutes), may remain occur for weeks to months
- History of cephalic or localized tetanus
- History of injury
Neonatal Tetanus
Neonatal tetanus may present with a history and symptoms of:[6]
- Generalized muscle spasms in a newborn
- History of unhygienic umbilical stump clamping
References
- ↑ "Tetanus | Symptoms and Complications | Lockjaw | CDC".
- ↑ Anisha Doshi, Clare Warrell, Dima Dahdaleh & Dimitri Kullmann (2014). "Just a graze? Cephalic tetanus presenting as a stroke mimic". Practical neurology. 14 (1): 39–41. doi:10.1136/practneurol-2013-000541. PMID 24052566. Unknown parameter
|month=ignored (help) - ↑ World Health Organization (2000-11-01). "Maternal and Neonatal Tetanus Elimination by 2005" (PDF). Retrieved 2007-01-26.
- ↑ Lisa Mitchell, William Adams & Francois Aspesberro (2017). "Case 6: Episodic Stiffness in a 30-month-old Girl". Pediatrics in review. 38 (1): 52–53. doi:10.1542/pir.2014-0142. PMID 28044038. Unknown parameter
|month=ignored (help) - ↑ Martha H. Roper, Jos H. Vandelaer & Francois L. Gasse (2007). "Maternal and neonatal tetanus". Lancet (London, England). 370 (9603): 1947–1959. doi:10.1016/S0140-6736(07)61261-6. PMID 17854885. Unknown parameter
|month=ignored (help) - ↑ Martha H. Roper, Jos H. Vandelaer & Francois L. Gasse (2007). "Maternal and neonatal tetanus". Lancet (London, England). 370 (9603): 1947–1959. doi:10.1016/S0140-6736(07)61261-6. PMID 17854885. Unknown parameter
|month=ignored (help)