Clinical picture
Incubation period: 1-14 days but may be longer
1- Mild tetanus
* Pain & stiffness at site of injury for few weeks
* Occur in patients who received the antitoxin before
* Mortality < 1%
2- Generalized tetanus (typical form)
* Spasms occur in descending form with intact consciousness:
- Trismus :difficult mouth opening due to massetter spasm.
- Risus sardonicus : grimacing face due to facial muscles spasm
- Langyngeal spasm --+ stridor & may be suffocation
- Opisthotonus --+ arched back
-Tonic seizures--+ flexed adducted arms & extended lower limbs with
colonic exacerbations.
* Spasms precipitated by visual or auditory stimuli
3- Cephalic tetanus
- Follow head injury or otitis media.
- Short incubation period with high mortality
-Involve cranial nerves palsy.
- May be followed by generalized form
4. Tetanus neonatorum (tetanus in newborn)
*
Infantile form of generalized tetanus
*
Manifest within 3-12 days of birth by:
- Progressive feeding difficulty with crying
- The umbilical stump may appear dirty (portal of entry of microbe)
-Paralysis
- Spasms and stiffness precipitated by touch
