The diagnosis of tetanus requires comprehensive consideration. If the patient has a history of trauma with skin or mucosal wounds, and shows signs of muscle spasms, such as difficulty opening the mouth, stiffening of the neck, and increased reflexes, the possibility of a tetanus infection should be considered. Further, a culture of the wound can be conducted to see if Clostridium tetani can be cultured. If the culture is positive, a definitive diagnosis can be made. Additionally, tetanus needs to be differentiated from other diseases such as purulent meningitis, rabies, epilepsy, hysteria, and so on.