Tetanus may follow trivial as well as overtly contaminated wounds, drug addicts in particular are prone to develop tetanus, as are patients with burns or surgical wounds. Clinical disease does not confer immunity. The toxin may enter the CNS along the peripheral motor nerves or may be blood- borne to the nervous tissue. The most frequent symptom is stiffness of the jaw .
Sphincteral spasm causes urinary retention or constipation.
Characteristic painful, generalized tonic spasms with profuse sweating are precipitated by minor disturbances such as a draft or noise or by jarring the bed. The patient's sensorium usually is clear, but coma may follow repeated spasms. Localized tetanus can occur, with spasticity of a group of muscles near the wound but without trismus. The spasticity may persist for weeks. Diagnosis A history of a wound in a patient with muscle stiffness or spasm is suggestive.