What are the clinical signs and symptoms of tetanus that I should be aware of during assessment?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

When assessing a patient for potential tetanus, you should be aware of the following clinical signs and symptoms:

  • Generalized Tetanus (the most common presentation):
    • Trismus (lockjaw) ,,.
    • Tonic contractions and spasms, which can lead to dysphagia (difficulty swallowing), opisthotonus (severe hyperextension and spasticity), and a rigid abdomen ,,.
    • In severe cases, these contractions and spasms may cause respiratory difficulties ,,.
    • Autonomic instability is typical ,,.
    • Consciousness is not affected ,,.
  • Localized Tetanus:
    • Characterized by rigidity and spasms confined to the area around the site of the infection ,,.
    • This form may be more common in partially immunized individuals ,,.
    • Localized symptoms can persist for weeks or may progress to generalized tetanus ,,.
  • Cephalic Tetanus:
    • This is a form of localized tetanus that occurs after a head or neck injury ,,.
    • It primarily involves the musculature supplied by the cranial nerves ,,.

The incubation period for tetanus is typically between 3 and 21 days, though it can range from one day to several months, depending on the wound's characteristics, extent, and location ,,. Tetanus is not spread from person to person ,,.

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