Diagnosis of Tetanus

Tetanus has become a rare disease in many countries since tetanus vaccine has become a part of routine childhood immunisation programmes. Many doctors may not ever see a patient with tetanus.

But even doctors who have never seen or diagnosed tetanus can easily recognise its symptoms.

Tetanus in most cases is diagnosed clinically based on medical history and physical examination.

Medical history: Some of the questions that the doctor may ask include:

• did you get injured in the resent past that caused skin breakage (but many people do not remember any injury and only about 70% have a known injury)?
• have you been immunised with tetanus vaccine?
• when did you receive your last dose of tetanus vaccine?

Physical examination: During physical examination, the doctor will check for muscle spasms and rigidity (such as in the facial region called lockjaw, difficulty in swallowing or at the site of injury).  In localised tetanus, pain, cramps, or muscle spasms occur at or near site of injury. The doctor will also note other findings such as temperature; changes in blood pressure (especially high blood pressure) and heart beat (irregular heartbeat). Neonates may show signs such as irritability, muscle spasms, and poor ability to take in liquids (poor sucking response).

Laboratory tests: In most cases, lab tests are not required to diagnose tetanus. If the diagnosis is doubtful, the doctor may do test to determine serum tetanus antitoxin levels. If you have serum antitoxin levels that are protective, diagnosis of tetanus is unlikely.