TETANUS — Clinical Features
High-yield causes
* Clostridium tetani spores enter through contaminated wounds (puncture wounds, dirty cuts)
* Produces tetanospasmin and blocks release of GABA + glycine from inhibitory interneurons and unchecked muscle contraction
Early symptoms
* Jaw stiffness and trismus (lockjaw)
* Neck stiffness
* Dysphagia may occur
* Restlessness / irritability may occur
Core generalized signs
* Trismus + risus sardonicus (facial grimace)
* Generalized rigidity (neck, back, abdomen)
* Painful tonic spasms
Opisthotonus (classic clue)
* Backward arching posture
* Severe extensor spasm of back and neck
* Suggests advanced generalized disease
Stimulus-triggered spasms
* Spasms triggered by noise, light, touch, movement
* Minor stimuli can provoke severe episodes (important bedside clue)
Swallowing / sphincter effects
* Dysphagia
* Urinary retention may occur
* Constipation may occur
Respiratory compromise (danger)
* Chest wall rigidity
* Laryngospasm / glottic spasm may occur
* Risk of respiratory failure
Autonomic instability
* Tachycardia
* Hypertension / labile BP
* Profuse sweating
* Sympathetic overactivity
Mental status clue
* Consciousness is often preserved
* Patient may remain aware during spasms (helps differentiate from some seizure states)
Medical disclaimer: Educational content only. Tetanus is a medical emergency—seek urgent care immediately for jaw stiffness, painful spasms, trouble swallowing/breathing, or a concerning wound in an inadequately immunized person.
