Tetanus natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural history
Complications
There are many complications associated with tetanus infection. Some of the complications are as follows:
- Laryngospasm
- This can be associated with spasms of the muscles of respiration which leads to breathing difficulties.
- Fractures of the spine or long bones
- This may result from prolonged contractions and convulsions
- Hyperactivity of autonomic nervous system
- This may lead to an abnormal heart rhythm and/or hypertension
- Nosocomial infections
- Common because of prolonged hospitalization
- There are commonly some secondary infections including:
- Sepsis from indwelling catheters
- Hospital-acquired pneumonia
- Decubitis ulcers
- Pulmonary embolism
- Apparent in drug users and the elderly
- Aspiration pneumonia
- Common late complication
- Found in 50%-70% of autopsied cases
Prognosis
Death in about 10-20% of cases, higher among older people.
In recent years:
- Tetanus has been fatal in approximately 11% of reported cases
- Most commonly fatal cases found in:
- People of 60 years or older (approximately 18%)
- Unvaccinated people (approximately 22%)
- In about 20% of deaths, no obvious pathology is detected
- Death is attributed directly to the direct effects of tetanus toxin.