Can tetanus be fatal?

Written by Li Jin Quan
General Surgery
Updated on September 12, 2024
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Tetanus can be fatal if not treated promptly. When infected with tetanus, early symptoms primarily include dizziness, headache, fatigue, decreased appetite, weak chewing, and sore jaw muscles, some may also exhibit increased reflexes or muscle rigidity. As the condition worsens, some patients show typical tetanus symptoms such as lockjaw, difficulty opening the mouth, risus sardonicus, opisthotonos, and stiff neck. As the condition further deteriorates, it can lead to difficulty breathing, or even respiratory arrest, and cardiac arrest. If not promptly rescued, the patient can die.

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Initial symptoms of tetanus

The bacterium that causes tetanus is Clostridium tetani, which is an anaerobic bacterium. If the wound is deep and enclosed in an environment lacking oxygen, it creates a suitable environment for the growth and reproduction of Clostridium tetani. Its incubation period is generally around one week. Early symptoms may include general fatigue, localized muscle tension, and uncontrollable spasms. The first muscles affected are usually the facial chewing muscles, and it can then progress to intense, spasmodic contractions of muscles throughout the body, and even cause fractures. Mild stimuli such as light, sound, or drinking water can trigger and worsen these symptoms, somewhat similar to rabies. However, a characteristic feature of tetanus is that the patient remains mentally clear. Most patients may die from respiratory spasms leading to asphyxiation, heart failure, or lung infections.

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Is it necessary to get a tetanus shot?

Getting a tetanus shot is very necessary if a patient has had an injury or has wounds on the body. Without a tetanus shot, there might be a risk of tetanus infection. The main reason is due to the presence of tetanus bacillus spores in the natural environment, which could colonize within the wound if it's exposed. This can potentially lead to a tetanus infection. Severe cases can present with symptoms such as opisthotonos, breathing difficulties, suffocation, and could even lead to death. The tetanus shot involves injecting tetanus antitoxin into the patient's body, which is a form of passive immunity and can prevent some symptoms of tetanus infection.

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Do you need a tetanus shot for a scraped skin?

Tetanus bacterial infection generally refers to relatively deeper wounds. A deeper wound creates an anaerobic environment locally, where tetanus-causing bacteria can reproduce and grow, leading to infection. If the wound is just a scrape and not deep, it's less likely to form an anaerobic environment. In such cases, the likelihood of developing tetanus is extremely low. From personal experience, if it's just a minor scrape, simply disinfecting the area with iodine is sufficient; there is generally no need for a tetanus antitoxin injection.

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How to treat tetanus?

Generally speaking, a tetanus shot needs to be administered intramuscularly, but a skin test must be conducted before injection because tetanus vaccines can easily cause allergic reactions. The skin test usually involves a subcutaneous injection on the palm side of the forearm, followed by an observation period of 15 to 20 minutes. If there is no redness or itching, and the skin test is negative, then the vaccine can be administered intramuscularly, usually in the buttock. However, if the skin test is positive, as indicated by symptoms like redness, significant itching, or even systemic symptoms such as dizziness and cold sweats, it shows that the skin test for tetanus is positive. In this case, one can opt for a desensitization injection of diluted tetanus vaccine, followed by intramuscular injections four times, once every half hour, needing about two hours to complete.

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Can I take a bath after getting a tetanus shot?

It's not recommended to take a bath immediately after receiving a tetanus shot. First, the wound requiring a tetanus shot may either be deep, heavily contaminated, or relatively large. After receiving a tetanus shot in the buttocks or the deltoid muscle of the upper arm, it is essential to enhance wound dressing changes and keep the wound dry, which is why bathing is not advised. If it's just a simple tetanus injection site, it can generally be exposed to water a few hours later. However, other wounds on the body should be kept dry. Therefore, it is better to take a bath when wounds on other parts of the body have healed well to avoid worsening infections and delaying healing.