The symptoms of tetanus may become evident any time for a few days to six weeks after the initial infection with Clostridium tetani bacteria. However, the standard incubation time is between five and ten days.
The most characteristic symptom of tetanus involves mild spasms in the jaw muscles that can cause the affected individual difficulty in opening their jaw. For this reason, tetanus is also sometimes referred to as “lockjaw”.
This stiffness of the jaw and neck is often one of the initial symptoms to present and helps to identify the disease as tetanus, but there are several other common symptoms of the disease.
The symptoms of tetanus may include:
- Dysphagia (difficulty swallowing)
- Fever - low
- Opisthotonos (back muscle spasms)
- Sore throat
- Stiffness of jaw and neck
- Stiffness of arms and legs
Initially, the symptoms of tetanus are usually localized to the area of the wound and then spread to the rest of the body. It is common to people infected with tetanus to develop a fixed expression, usually with a tight smile and arched eyebrows, as a result of the muscle contractions in the facial area.
As the infection spreads and the disease becomes more severe, individuals may have difficulty opening the jaw and controlling other areas of the body. Muscle spasms in the back, neck and abdomen may be evident. This occurs particularly when the individual becomes stressed and may lead to profuse sweating and whole-body spasms that are considerably painful. Some patients may experience constipation or retention of urine as a result of the muscle rigidity in these areas.
Despite significant muscular rigidity and inability to control movements, people with tetanus are usually mentally alert. With adequate treatment, tetanus is usually a short-term condition and the symptoms are likely to pass after approximately two to four weeks.
Some individuals with tetanus experience life-threatening complications that may be fatal. These should be addressed as soon as possible to minimise the damage to the patient and promote a health recover.
Complications that arise due to the muscular spasms of the entire body include:
- Bone fractures
- Muscle tears
- Skin sores
In some cases, patients may have difficulty speaking or breathing due to muscular spasms in the chest and throat. In fact, the most common fatalities of tetanus are related to breathing difficulty and suffocation due to muscular rigidity of the respiratory system. Death due to respiratory failures accounts approximately 10-20% of tetanus cases. This may include:
- Breathing difficulty and suffocation
- Pulmonary Embolism
- Respiratory failure
Blue lips and nails are an indicative sign of insufficient oxygen in the bloodstream, which can arise due to breathing difficulties.
Additionally, some other complications may occur in the medical setting and result in serious outcomes. For example, a secondary infection can sometimes be acquired in a hospital environment. Low blood pressure, or hypotension, can also lead to unwanted outcomes that can complicate the treatment of the patient.