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    Clinical Overview Clinical Guidance Clinical Features Vaccine Recommendations Clinical Care and Treatment View All
August 15, 2024
  Clinical Features of Tetanus
          Key points
            * There are three forms of tetanus with varying clinical presentations.
            * Tetanus is diagnosed based on clinical signs and medical history.
            * There are no laboratory tests to support or rule out tetanus diagnosis.
            * Tetanus is a medical emergency that requires hospitalization and often causes complications.
        Clinical presentations
        There are three forms of tetanus:
          * Generalized
          * Localized
          * Cephalic
        Generalized
        Generalized tetanus is the most common form of the disease. It accounts for more than 4 in 5 cases.
        Neonatal tetanus is a form of generalized tetanus. It occurs in newborns who lack the passive protection derived from maternal antibodies.
        Localized
        Localized tetanus is an unusual form of the disease. It's possible for it to progress to generalized tetanus.
        It typically occurs in people with partial tetanus immunity.
        Cephalic
        Cephalic tetanus is the rarest form. It's associated with lesions of the head or face. It may be associated with otitis media. It's possible for it to progress to generalized tetanus.
        Common signs and symptoms
          This baby has bodily rigidity due to neonatal tetanus.
        Generalized tetanus
        Painful muscular contractions are characteristic of tetanus:
          * Difficulty in swallowing or breathing
          * Generalized spasms (frequently induced by sensory stimuli)
          * Rigidity
          * Seizures
          * Trismus, or lockjaw painful muscle contractions
        Localized tetanus
        Like generalized tetanus, localized tetanus is characterized by painful muscle spasms. However, they're in a confined area close to the injury site.
        Cephalic tetanus
        Unlike the other two forms, cephalic tetanus results in flaccid cranial nerve palsies rather than spasm.
        Common first signs in older children and adults‎
        Abdominal rigidity is a common first sign suggestive of tetanus in older children and adults. However, it's sometimes confined to the region of injury. Generalized spasms occur, frequently induced by sensory stimuli.
        Clinical assessment
          CDC doesn't perform tetanus testing‎
              CDC doesn't conduct tetanus testing including serologic tests. There are no laboratory tests that can diagnose or rule out a tetanus diagnosis.
        Tetanus is a clinical syndrome. Healthcare providers diagnose tetanus based on clinical presentation consistent with tetanus, in the absence of an alternative or more likely cause. There are no diagnostic tests that can support or rule out tetanus. Culture can lead to both false-positive and false-negative results. Serologic studies can't reliably evaluate individual-level tetanus immunity.
        Note: History of an injury or apparent portal of entry may be lacking. In addition, healthcare providers rarely recover tetanus bacteria from the site of infection.
          Keep Reading: Clinical Care of Tetanus
        Complications
        Nervous system abnormalities, as well as a variety of complications related to severe spasms and prolonged hospitalization, can accompany generalized tetanus.
        Complications of tetanus can also include:
          * Aspiration pneumonia
          * Fractures
          * Hypertension
          * Laryngospasms
          * Nosocomial infections
          * Pulmonary embolism
          * Death
        On This Page
            * Clinical presentations
            * Common signs and symptoms
            * Clinical assessment
            * Complications
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  August 15, 2024
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        National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases
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    Tetanus
    Tetanus is an uncommon but serious infection caused by bacteria found in the environment. The best way to prevent tetanus is to get vaccinated.
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