Tetanus: Pathophysiology, Clinical Presentation, Management & Differential Diagnosis

Tetanus is a bacterial infection caused by Clostridium tetani, a gram-positive obligate anaerobic bacterium commonly found in soil that enters the body through a contaminated wound. C. tetani produces a neurotoxin that blocks the release of inhibitory neurotransmitters and causes prolonged tonic muscle contractions. It presents with lockjaw, neck stiffness, opisthotonus, rigid abdomen and severe painful muscle spasms.

Diagnosis is made on clinical grounds, as it is rarely possible to isolate the infectious agent from the wound. It is treated with antibiotic therapy and human tetanus immune globulin (HTIG). Untreated tetanus can lead to respiratory failure and cardiovascular complications and can be fatal. With appropriate treatment, however, most patients will recover.