Lockjaw

WHAT YOU SHOULD KNOW

Lockjaw is an infection that causes extreme muscle stiffness and spasms. Also referred to as tetanus, it's easily prevented with shots of tetanus vaccine, which are usually given in infancy. Protection eventually wears off, so a booster is recommended every 10 years.

Causes

Lockjaw is caused by germs called Clostridium tetani, which live in the soil. These bacteria typically enter the body through a puncture wound, such as one caused by stepping on a nail. Once inside the body, the bacteria produce a toxin that attacks the nerves in control of the muscles, thereby causing severe spasms.

Signs/Symptoms

The first symptoms typically appear within four to 25 days after infection. At the outset, you'll be troubled by painful muscle stiffness and spasms in the jaw and neck (from which the disease derives its name). Gradually, the back, chest, abdomen, and limbs also become affected. High fever, convulsions, restlessness, difficulty swallowing, fever, sore throat, chills, and extreme pain may eventually join the initial symptoms.

Care

Treatment includes a number of drugs. Muscle relaxants are prescribed to ease muscle contractions. Antibiotics are given to fight the infection. Antitoxin injections in the afflicted muscles help halt the progress of the disease, but will not counteract the toxin already in your system or relieve symptoms already present. Intravenous nutritional fluids may also be given. If your breathing is disrupted, an artificial respirator may be needed.

Risks

Although rare in the United States thanks to the tetanus vaccine, lockjaw kills three out of 10 victims if left untreated. A serious case can cause a full body spasm, making breathing, speaking, and crying out impossible, and leading to oxygen deprivation and suffocation.

WHAT YOU SHOULD KNOW

• Clean all puncture wounds with warm soapy water.
• Apply an antiseptic cream and cover the wound with a bandage.

Seek Care Immediately If...

• You suffer from a deep puncture wound and have not had a tetanus booster shot within five years.
• You begin experiencing symptoms that may signal lockjaw, such as severe, painful muscle contractions.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Taking Vital Signs: These include your temperature, pulse, blood pressure, and respiration. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm. These tests may be performed hourly.
• IV: A tube placed in your vein for giving medications and nourishment. It will either be capped or have tubing connected to it.
• Wound Culture: This diagnostic procedure is usually performed by a nurse, who inserts a swab or syringe deep into the wound to collect a specimen of any infecting bacteria. For a deep wound in which lockjaw is suspected, an anaerobic culture is needed. This type of test detects organisms, such as Clostridium , that cannot live in the presence of oxygen
• Debridement: This procedure removes dead tissue from a wound. The dead tissue may be cut out or flushed out with a saline solution.
• Oxygen: Your body may need extra oxygen. It is given by either a mask or nasal prongs.
• Catheter: This is a thin tube which is inserted through your urethra and into your bladder to remove urine. You may also have a rectal catheter inserted to remove other body wastes.
• Medicine:
  • Tetanus immune globulin will be given to neutralize the toxin.
  • Antibiotics will be given to kill the bacteria and thereby prevent further toxin production. These drugs are usually given through your IV.
  • Muscle relaxants will be given to control muscle spasms.
  • Analgesics may be given to control pain.
  • Sedatives , administered in low doses, may be given to relieve stress and anxiety.
• MRI: This machine produces images of your internal organs that can help the doctors assess the extent of the muscle damage you may have suffered. To get the pictures, you will need to lie on a narrow bed that slides into a scanner.
• Electrocardiogram: Also known as an ECG, EKG, or heart monitor, this diagnostic tool employs electrodes, or patches, placed on your chest. The patches are hooked up to a TV-type screen or small portable box that shows a tracing of each heartbeat.
• Respirator: This is a device used to maintain normal breathing movements should chest muscles become affected by the spasms.
• Pulse Oximeter: This is a clip placed on your ear, finger, or toe, and connected to a machine that measures the oxygen in your blood.
• Neuro Signs: The doctor will check your eyes and memory and test how easily you awaken.
• Blood: Samples taken from a vein in your hand or the bend in your elbow will be used to test for tetanus antibodies. To check the oxygen level in your blood, additional samples may need to be drawn from the wrist, elbow, or groin.

After You Leave

• You'll need a full series of tetanus shots after you recover, since the infection will not give you immunity to subsequent infections.
• Take your medications directly as prescribed by your doctor. Do not stop taking the medications until the prescription runs out, even if you feel well.
• Rest in bed in a quiet, dimly lit room for a few days.
• Limit your normal activities as much as possible for several days.

Seek Care Immediately If...

• You notice signs of infection such as redness, pain, drainage, or swelling around the puncture wound.
• The site of a vaccination shot stays tender, red, or swollen for more than 48 hours.
• You develop a fever that lasts for more than 48 hours.

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