Tetanus, also known as lockjaw, is a serious illness caused by a bacterial toxin that affects the nervous system and causes muscle spasms. It can be life-threatening if not treated quickly. Tetanus does not spread from person to person. It’s caused by a toxin produced by Clostridium tetani, a type of bacteria found in soil, dust, and manure. The bacteria enter the body through breaks in the skin, like cuts or puncture wounds. When you have tetanus, you may begin to feel generally unwell and experience the following symptoms:
Muscle spasms and stiffness – Spasms usually begin in the jaw, which is why tetanus is often called “lockjaw”. The spasms can spread to the neck, arms, legs, and abdominal muscles. Muscles near the site of the infection are more likely to spasm. Muscle stiffness and difficulty swallowing are common.
Painful body spasms – The muscle spasms can be severe and occur frequently for 3-4 weeks. Even a slight touch, breeze, or loud noise can trigger spasms. The spasms can cause fractures of the spine and other bones.
Breathing problems – As the spasms spread to the chest and abdominal muscles, they can interfere with breathing, putting someone with tetanus at risk of asphyxiation.
Fever and sweating – A person with tetanus may develop a fever and sweating as their body tries to fight off the tetanus bacteria.
High blood pressure and a fast heart rate – The nervous system reactions that cause the muscle spasms can also drive up blood pressure and elevate heart rate.
So in summary, the main symptoms that make you feel unwell with tetanus are painful muscle spasms and stiffness, trouble breathing, fever, sweating, and elevated heart rate and blood pressure. The muscle spasms begin in the jaw and spread, causing “lockjaw”, stiffness, and whole-body convulsions triggered by touch, noise, or breeze. Let’s go over these symptoms in more detail.
Muscle Spasms and Stiffness
The most characteristic signs of tetanus are muscle spasms and stiffness. The first muscle affected is usually the masseter muscle in the jaw, causing lockjaw. Stiffness and difficulty opening the mouth are the first symptoms that alert doctors to suspect tetanus.
The muscle spasms then typically spread down to the neck, causing stiffness and trouble swallowing. From the neck, the spasms can radiate out to the arms, back, abdominal muscles, and legs. Even the muscle groups controlling the bladder and anus can be affected.
These muscle spasms occur because the tetanus toxin produced by the bacteria blocks neurotransmitters that control muscle contractions. This leads to uncontrolled, painful cramping of the muscles.
The spasms last for 3-4 weeks on average. They can recur frequently, sometimes many times per hour. Minor stimuli can trigger a sudden, severe, whole-body spasm. Things like a light touch, a gust of air, a loud noise, or even the motion of lying down can set off a seizure-like tetanic spasm.
As the muscle groups contract uncontrollably, they can cause fractures of the spine and other bones. The breathing muscles can clench up, causing life-threatening breathing problems. Death from tetanus is usually due to spasms affecting the respiratory muscles.
Symptoms of Muscle Spasms
– Lockjaw, stiffness in the jaw muscles
– Difficulty swallowing
– Stiff neck
– Painful tightening of the arm, leg, and back muscles
– Abdominal muscle spasms
– Painful convulsive spasms of the whole body
– Spasms triggered by touch, air currents, noises
– Spasms leading to bone fractures and breathing difficulties
Breathing Problems
As mentioned, the muscle spasms of tetanus can interfere with breathing by constricting the respiratory muscles. Spasms of the diaphragm and intercostal muscles between the ribs make it very difficult for patients to breathe.
Breathing difficulty usually develops 2-4 days after other tetanus symptoms first appear. It begins with labored breathing as the chest muscles stiffen. As spasms worsen, breathing can become completely obstructed.
Besides muscle spasms, breathing problems can arise from:
– Blockage of upper airways by mucus, swollen airway linings, or saliva
– Pneumonia due to muscle spasms allowing food or liquids to enter the lungs
– Laryngospasms that close off the windpipe
Proper breathing support is a vital part of tetanus treatment. Patients are given oxygen, extra airway protection, and often need to be placed on mechanical ventilation. Even with respiratory support, many tetanus patients succumb to fatal spasms or respiratory failure.
Symptoms of Breathing Problems
– Labored, difficult breathing
– Wheezing or gasping for air
– Bluish discoloration of the skin, lips, and nail beds (cyanosis)
– Obstructed airways from mucus, swelling, or saliva
– Aspiration pneumonia after food/liquid enters lungs
– Laryngospasms closing the windpipe
– Respiratory failure
Fever and Sweating
Most people with tetanus develop an elevated body temperature or fever. The fever is a sign of the body’s immune response as it tries to fight the tetanus infection.
Fevers from tetanus tend to rise rapidly, spiking to over 102°F (39°C). High, uncontrolled fevers can cause sweating, chills, and flushing of the skin.
Fever and autonomic instability add to the metabolic stress of severe tetanus. Increased heart rate, blood pressure, and breathing drive up the body’s demand for oxygen and nutrients.
Along with fever care, it’s important to provide extra nutritional support for tetanus patients. Those with difficulty swallowing may need to receive fluids and nutrition intravenously. Controlling fever with medications helps reduce the risk of exhaustion and metabolic dysfunction.
Symptoms of Fever and Sweating
– High fever, often spiking over 102°F (39°C)
– Profuse sweating
– Chills and shivering
– Flushed or pale skin
– Increased heart rate and respiration
– Metabolic disturbances from hyperpyrexia
Fast Heart Rate and High Blood Pressure
The tetanus toxin causes excessive stimulation of the sympathetic nervous system. This drives up heart rate and blood pressure.
Tachycardia, or rapid heart rate, is common in those with severe tetanus. Heart rates over 140 bpm are typical. This places extra strain on the heart.
Blood pressure also increases due to tetanus. The sudden spikes in blood pressure during muscle spasms can be extremely dangerous. They can lead to stroke, heart attack, or aortic aneurysm.
Metabolic acidosis often accompanies the cardiovascular effects. These complications add to the mortality risk for people with tetanus. Careful monitoring and management of heart rate and blood pressure are necessary.
Symptoms of Cardiovascular Disturbances
– Tachycardia – resting heart rate over 100 bpm
– Heart palpitations
– Hypertension – blood pressure over 140/90 mmHg
– Blood pressure spikes with muscle spasms
– Stroke risk from high blood pressure
– Heart attack risk from increased demand on the heart
– Metabolic acidosis
Additional Symptoms
A few other signs and symptoms may occur with tetanus in some cases:
– Headache – From muscle spasms and elevated blood pressure
– Irritability – Due to overstimulation of the nervous system
– Restlessness and anxiety – Related to increased autonomic arousal
– Trouble sleeping – Difficulty relaxing and lying still due to spasms
– Sweating and goosebumps – From autonomic instability
– Mild abnormal blood counts – The immune response may alter some lab results
– Loss of bladder/bowel control – Due to muscle spasms
Conclusion
Tetanus is characterized by progressive muscle spasms and autonomic instability. The first sign is typically lockjaw. Muscle stiffness and painful convulsions then spread throughout the body, often triggered by minor stimuli. Breathing problems, high fever, elevated heart rate, and hypertension frequently occur.
Metabolic and respiratory support are crucial, as many tetanus deaths result from fever, cardiovascular complications, or suffocation due to muscle spasms. Rapid treatment with tetanus immune globulin and antibiotics is needed to neutralize the toxin and fight the infection before it overwhelms the body.
Tetanus Symptoms Summary Table
| Symptom Category | Specific Symptoms |
|---|---|
| Muscle spasms/stiffness | Lockjaw, stiff neck, muscle convulsions, triggered spasms, difficulty swallowing |
| Breathing problems | Labored breathing, obstructed airway, cyanosis, aspiration pneumonia |
| Fever/sweating | High fever, chills, flushed skin, sweating |
| Cardiovascular effects | Tachycardia, hypertension, blood pressure spikes, stroke risk |
| Other symptoms | Headache, irritability, insomnia, bladder/bowel issues |
