Tetanus is a disease that is capable of infecting the entire population. However, there is a greater risk in certain professions, being in these cases a disease whose cause has an origin and a direct relationship with work.
Tetanus is a very serious disease that in most cases leads to the death of the patient, but nevertheless has an effective prophylaxis that can prevent it, while there is no effective treatment to cure it in all cases when it is already installed.
How Do You Know If You Have Tetanus?
The diagnosis of tetanus is usually established by clinical observations. Cultures of the wound should be done in an anaerobic environment.
The large increase in tone in the central muscles (face, neck, thorax, back, and abdomen) with generalized spasms added, with little involvement of the hands and feet, decisively guide the diagnosis of tetanus.
Incubation Period of Tetanus
The incubation period of tetanus is the interval time between the invasion by an infectious agent and the appearance of the first signs or symptoms of the disease. The average incubation period in tetanus disease oscillates between 3 and 21 days, although its duration may be longer in people who are incompletely protected. As a general rule, a shorter incubation period implies a greater severity of the disease.
There is also the period of invasion, which is the period between the onset of symptoms and the full development of them. This period of invasion has a higher prognostic value than that of incubation; with the prognosis being worse the shorter the time elapsed.
Initial Phase of Tetanus
The main symptom in the vast majority of cases of tetanus is trismus, which consists of a difficulty to completely open the mouth and is typically painless. It is a sign of easy assessment by the clinician and along with the history of a dirty wound and a complete clinical history always guides doctors to the diagnosis of tetanus pathology.
The trismus can disappear early in the state phase by early treatment, and even spontaneously. Also, in this phase of tetanus, we can find a contracture of the muscles that are close to the dorsal and lumbar muscles, along with a feeling of general discomfort similar to a flu-like illness.
Status Period for Tetanus
The generalized contractures of the entire musculature mark the state phase. They are sustained tonic contractures with paroxysmal exacerbations of the muscle triggered by different stimuli such as injection, noise, and many others are equally disparate.
These exacerbations are not the typical contractions followed by relaxation such as tonic-clonic epilepsy but are very intense increases in tone on a permanent contraction background.
Another characteristic tetanus sign is sardonic laughter, which is due to the gesture adopted by the face by the contraction of the facial muscles and consists of a frowning of the eyebrows, with a very marked nasolabial groove and the half-closed eyes.
The rest of the voluntary musculature is also affected, causing stiff neck, limbs, trunk and, finally, the abdomen.
Severe spasms and convulsions occur in severe cases that affect the extremities, the trunk muscles (producing a deformity of the posture with a great curvature of the spine or opisthotonos), the respiratory muscles and those of the glottis producing phenomena of suffocation that in some cases are lethal. These crises can last seconds or several minutes and are triggered, as already said before, by the most varied stimuli.
Other affected muscles are those of the pharynx and some of the smooth muscles, the most predominant condition being that of the urinary system, which sometimes causes retention of urine.
These described crises do not appear in all cases and are usually rare in mild cases. Other nonspecific symptoms that appear in tetanus disease are fever, diaphoresis (abundant sweating), tachycardia, and the sympathetic hyperactivity syndrome.
Currently, and thanks to the treatment with relaxers, tracheotomy and assisted breathing, these entire described clinic is not as florid, but new problems appear such as the side effects of the used drugs (relaxation of the muscles, increased secretions, abdominal distension, etc.).
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