Tetanus is a serious and potentially fatal disease. Prompt diagnosis and treatment are vital in order to improve the prognosis of tetanus. Some factors which increase the risk of severe disease and therefore poor prognosis are:
- Short incubation period (time from injury to first symptom) – Incubation period of less than seven days increases the risk of disease getting severe. Death rate is nearly 100% if symptoms begin within one to two days.
- Time from first symptom to first spasm – If it is less, the risk of disease getting severe is increased.
- Site of infection – Infection of the umbilical, uterine, head, and neck predict more severe disease.
- Extremes of age – In newborns and elderly.
- Lack of immunity – No previous tetanus vaccine.
Prognosis of tetanus
Neonatal tetanus has poor prognosis. A newborn baby is at risk of tetanus if contaminated knife, razor, or other instrument is used to cut its umbilical cord, or if dirty material is used to dress the cord. In infants less than 10 days old, incidence of disease getting severe and therefore, risk of poor prognosis is more. Symptoms include presence of risus sardonicus and fever.
Risk of death is significantly increased in newborns with an incubation period of six days or less and weight less than 2.5 kg.
Tetanus is life-threatening disease if the patient does not receive treatment promptly. According to studies, mortality rates vary from 40% to 78%. Older people and those who have a rapid progression of symptoms have poor prognosis. In adults, acute respiratory failure is the leading cause of death in tetanus. Risk of severe disease is to 35% to 40% if the incubation period is greater than 10 days.
Recovery is complete if the person survives the infection, i.e. there is no residual damage to brain or body in most cases.
Some possible complications of tetanus
- Fractures: They can sometimes be caused in case of severe muscle spasms and convulsions. Fractures may occur in the patient's back, limbs, as well as some other bones.
- Aspiration pneumonia: Patients with tetanus can develop aspiration pneumonia if secretions or contents of the stomach are inhaled.
- Laryngospasm: If the muscles of larynx (voice box) are affected, it can go into a spasm and cause breathing difficulties. In severe cases the patient can suffocate.
- Tetanic seizures: In severe cases the infection may spread to the brain and the patient can have epileptic-like fits (seizures).
- Severe kidney failure (acute renal failure): In severe muscle spasms, destruction of skeletal muscle protein known as myoglobin can occur. It is normally eliminated by the kidney and removed from the body through urine. If excessive destruction of myoglobin occurs, it can cause acute renal failure (severe kidney failure).