Tetanus, also known colloquially as lockjaw from its most common symptom, is an infectious but non-contagious bacterial disease caused by a bacteria in the Clostridium family. It is usually only affects patients who have received deep or severe wounds, including broken bones. The tetanus bacteria is common in the environment, but is not very virulent, although it can survive in the environment for lengthy periods of time. It is commonly found in soil.

Once a patient is infected, skeletal muscles become painfully contracted as a toxin produced by the bacteria interferes with muscle function, keeping the muscle from relaxing. If the disease spreads to the back, it can cause painful arching. Luckily, because they function differently, non-skeletal muscles such as those in the heart are not affected.

The incubation period of tetanus generally depends on how far the wound is from the central nervous system. It can be as short as eight days or as long as six months. The disease is generally more severe when it presents quickly.

In a patient with symptoms, metronidazole is the antibiotic of choice. Penicillin is avoided because it is believed the drug will make the spasms worse.

In a patient coming to the emergency room with a severe cut or puncture, a tetanus vaccination is routine as the vaccine can build up antibodies to the disease faster than the disease will. Children are often routinely vaccinated for tetanus, but the immunity given by the vaccine does wear out with time and booster shots are necessary. In addition, any wound should be thoroughly cleaned to remove any trace of dirt or soil as they can harbor the pathogen.

Diagnosis of tetanus is difficult because even in infected patients, the bacteria can often not be found in blood cultures. As such, diagnosis has to be based on the progression of symptoms.

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