How Do Doctors Make the Diagnosis?

The diagnosis is made based on the presence of symptoms and the patient's history (for example, getting a wound by stepping on a soil-contaminated nail). Laboratory tests are not useful in determining whether a patient has tetanus. A culture of the wound can be done, but these cultures generally do not show the bacteria.

What Is the Treatment for Tetanus?

Typically, tetanus infection is treated in a hospital. Treatment begins with giving the patient tetanus immune globulin to control or reverse the effects of toxin that has not yet attached itself to nerve endings. Penicillin or other antibiotics also may be given to kill the bacteria. Cleaning the wound and removing dead tissue, in some cases by surgery, is important in ridding the body of invading bacteria. Muscle spasms can be treated with muscle relaxants. Respiratory system support, provided by a respirator may be necessary to help maintain breathing if the respiratory muscles have been affected.

How Long Does Tetanus Last?

Symptoms may last three to four weeks, although complete recovery can take several months. Tetanus can be mild, but in most cases the illness is severe and death may occur even after treatment has begun. Tetanus usually requires a long stay in the intensive care unit of the hospital.

What Are the Complications?

Complications of the illness include spasms of the vocal cords and the muscles that control breathing, which can lead to difficulty breathing; fractures in the long bones or the spine from severe muscle spasms and convulsions; high blood pressure; abnormal heart rhythm; secondary infections, such as sepsis and pneumonia (inflammation of the lung); a blood clot in the lungs; and death. In the United States, 10 to 20 percent of reported tetanus cases are fatal. Unvaccinated children and the elderly are at greater risk of dying if they become infected with tetanus bacteria.

Can Tetanus Be Prevented?

Immunization is the best means of preventing tetanus. The vaccination usually is given in combination with other vaccines: the DTaP (diphtheria/ tetanus/ acellular/ pertussis) form for children and the Td (tetanus/diphtheria) form for adults. A series of shots is required to develop immunity to tetanus toxin, followed by booster shots every 10 years. In some cases of unclean wounds, a booster is given after the injury to help prevent tetanus.

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