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signs and symptoms of tetanus?


The first signs of tetanus infection are usually a headache and spasms or cramping of the jaw muscles (lockjaw). As the poison spreads, it progressively attacks more groups of muscles, causing spasms in the neck, arms, legs, and stomach, and sometimes violent convulsions (seizures).

 How soon after exposure do symptoms appear?

The time between the contamination of a wound and the first symptoms is usually less than 2 weeks but can range from 2 days to months. In general, the shorter the time between exposure and symptoms, the more severe the disease.

 he hallmark feature of tetanus is muscle rigidity and spasms

  • 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.

Figure 2: Picture of opisthotonus or arched back due to muscle spasms in a person with generalized tetanus; SOURCE: CDC

  • 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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