Tetanus natural history

Complications
There are many complications associated with tetanus infection. Some of the complications are as follows:


 * Laryngospasm
 * This can be associated with spasms of the muscles of respiration which leads to breathing difficulties.
 * Fractures of the spine or long bones
 * This may result from prolonged contractions and convulsions
 * Hyperactivity of autonomic nervous system
 * This may lead to an abnormal heart rhythm and/or hypertension
 * Nosocomial infections
 * Common because of prolonged hospitalization
 * There are commonly some secondary infections including:
 * Sepsis from indwelling catheters
 * Hospital-acquired pneumonia
 * Decubitis ulcers
 * Pulmonary embolism
 * Apparent in drug users and the elderly
 * Aspiration pneumonia
 * Common late complication
 * Found in 50%-70% of autopsied cases

Prognosis
Death in about 10-20% of cases, higher among older people.

In recent years:


 * Tetanus has been fatal in approximately 11% of reported cases
 * Most commonly fatal cases found in:
 * People of 60 years or older (approximately 18%)
 * Unvaccinated people (approximately 22%)
 * In about 20% of deaths, no obvious pathology is detected
 * Death is attributed directly to the direct effects of tetanus toxin.