Diagnosis

Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren't helpful for diagnosing tetanus.

Treatment

Since there's no cure for tetanus, treatment consists of wound care, medications to ease symptoms and supportive care.

Wound care

Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound.

Medications

  • Antitoxin. Your doctor may give you a tetanus antitoxin, such as tetanus immune globulin. However, the antitoxin can neutralize only toxin that hasn't yet bonded to nerve tissue.
  • Antibiotics. Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria.
  • Vaccine. All people with tetanus should receive the tetanus vaccine as soon as they're diagnosed with the condition.
  • Sedatives. Doctors generally use powerful sedatives to control muscle spasms.
  • Other drugs. Other medications, such as magnesium sulfate and certain beta blockers, might be used to regulate involuntary muscle activity, such as your heartbeat and breathing. Morphine might be used for this purpose as well as sedation.

Supportive therapies

Severe tetanus infection often requires a long stay in an intensive care setting. Since sedatives can inhibit breathing, you might temporarily need a ventilator.

Lifestyle and home remedies

Puncture wounds or other deep cuts, animal bites, or particularly dirty wounds put you at increased risk of tetanus infection. Get medical attention if the wound is deep and dirty, and particularly if you're unsure of when you were last vaccinated. Leave unclean wounds open to avoid trapping bacteria in the wound with a bandage.

Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you've previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus.

If you have a minor wound, these steps will help prevent tetanus:

  • Control bleeding. Apply direct pressure to control bleeding.
  • Keep the wound clean. After the bleeding stops, rinse the wound thoroughly with clean running water. Clean the area around the wound with soap and a washcloth. If something is embedded in a wound, see your doctor.
  • Use an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment, such as the multi-ingredient antibiotics Neosporin and Polysporin. These antibiotics won't make the wound heal faster, but they can discourage bacterial growth and infection.

    Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.

  • Cover the wound. Exposure to the air might speed healing, but bandages can keep the wound clean and keep harmful bacteria out. Blisters that are draining are vulnerable. Keep them covered until a scab forms.
  • Change the dressing. Apply a new dressing at least once a day or whenever the dressing becomes wet or dirty to help prevent infection. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and paper tape.

Preparing for your appointment

If your wound is small and clean but you're concerned about infection or whether you're immune from tetanus, start by seeing your primary care provider. If your wound is severe or you or your child has symptoms of tetanus infection, seek emergency care.

What you can do

If possible, let your doctor know the following information:

  • When, where and how you were injured
  • Your immunization status, including when you received your last tetanus booster shot
  • How you've been caring for the wound
  • Any chronic illness or condition you have, such as diabetes, heart disease or pregnancy

If seeking care for an infant other than your own, let the doctor know the mother's country of origin, her immune status and how long she's been in the United States.

For tetanus, some basic questions to ask your doctor include:

  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I manage them together?
  • Do I need to see a specialist?
  • Are there restrictions I need to follow?
  • Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

If a wound is obvious, your doctor will inspect it. He or she will likely ask you a number of questions, including:

  • Have you had tetanus symptoms, such as muscle spasms, and, if so, when did they start?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve or worsen your symptoms?
  • When were you last vaccinated for tetanus and what type of vaccine did you receive?
  • Have you recently had a wound (if not obvious)?
Aug. 08, 2017
References
  1. Sexton DJ. Tetanus. http://www.uptodate.com/home. Accessed Feb. 8, 2016.
  2. Baddour LM, et al. Infectious complications of puncture wounds. http://www.uptodate.com/home. Accessed Feb. 8, 2016.
  3. Tetanus. Centers for Disease Control and Prevention. http://www.cdc.gov/tetanus/about/index.html. Accessed Feb. 8, 2016.
  4. Tetanus. Vaccines.gov. http://www.vaccines.gov/diseases/tetanus/. Accessed Feb. 8, 2016.
  5. Lacerations. Merck Manual Professional Version. http://www.merckmanuals.com/professional/injuries-poisoning/lacerations/lacerations?qt=cuts%20and%20scrapes&sc=&alt=sh. Accessed Feb. 8, 2016.