A Family Doctor's Tale - TETANUS

DOC I HAVE TETANUS

Tetanus is a very potentially dangerous disease. I have one patient (my one and only ) who is alive today although she had a almost fatal episode of tetanus infection and was rescusitated after her heart and lung stopped muscle movement.

The danger of tetanus was  that the muscles of the body go into spasm(locked) and the heart stopped and the breathing also stopped because the muscles goes into spasm.

After getting a history of being treated with with rusty dental instruments and the resulting stiffness of one side of her jaw, I sent her immediately to hospital where her heart stopped and was rescusitated back to life. She was very lucky to be alive. I was very angry at the unhygienic dentist.


Tetanus is an acute infectious disease caused by the bacteria Clostridium tetani which lives in the soil.

Tetanus is transmitted by bacterial spores of the tetanus bacteria entering a wound in the skin of a person such as wounds caused by rusty nails.

When the spore developed into the tetanus bacteria, it can produce a powerful toxin which can cause the muscles to go into spasm.

In the jaw the muscle may go into spasm causing a condition called lockjaw.

In more severe cases the respiratory muscles can go into spasm resulting in stoppage of  breathing and therefore loss of oxygen to the brain and heart.

This usually results in death unless treated.

The infections occur in persons of all ages.

There is usually a history of a wound, laceration or operation with contamination of soil or rust in nails or surgical instruments.

Symptoms start off with:

1. irritability

2. fever

3. muscle cramps

4. lockjaw

5. difficulty in breathing or swallowing

Complications of tetanus occur when the muscle spasm affect the respiratory muscles resulting in inability to breathe.

The loss of oxygen to the heart can cause the heart to stop.

The loss of oxygen to the brain can cause the brain to stop functioning resulting in death.

Diagnosis of Tetanus :


The detection of tetanus bacterium in the wound can confirm tetanus infection.

Treatment of Tetanus is by:


Isolation in hospital is necessary.

1.Antibiotics (metronidazole) are used in the treatment of Tetanus.

2.Antitoxin can be given by intramuscular injection

3.Intravenous fluids given for dehydration

4.Respirator is used if breathing stops from spasm of respiratory muscles or vocal muscles

5.Proper wound cleansing is important to remove the infectious spores


6.Cardiac failure should be treated

Vaccination against Tetanus is the best prevention .

Since vaccination began, the worldwide incidence of Tetanus has declined.

Vaccination against Tetanus, pertussis (whooping cough), tetanus (DPT) is usually given to

1.a baby at 3 months of age and repeated at 4 and 5 months of age.

2.a booster vaccination at 18 months.

In adults tetanus vaccines are given in all cases of wounds:

first dose followed by a

second dose 6 weeks later and

third dose  6 months later and

fourth dose 18 months later

Besides the vaccinations there should be proper washing of wounds and avoidance of use of rusty instruments.

Prognosis in Tetanus is still not very good because by the time diagnosis is made complications may have set in.


Death occurs in 30% of cases.

Mortality is highest in very young children and adults over 50.

Death is usually due to respiratory failure or heart failure.