Tetanus, also known as lockjaw, is a serious bacterial infection that affects the nervous system and causes muscle spasms. If left untreated, tetanus can be fatal. Here is an overview of what happens when tetanus goes untreated:
Introduction to Tetanus
Tetanus is caused by the bacterium Clostridium tetani. The bacteria are found in soil, dust, and manure and enter the body through breaks in the skin, like cuts or puncture wounds. The bacteria produce a toxin that affects the nerves and causes muscle spasms and stiffness, especially in the jaw and neck muscles.
Common initial signs and symptoms of tetanus include:
- Lockjaw
- Stiffness in the neck, shoulder, and back muscles
- Difficulty swallowing
- Muscle spasms
- Fever
- Elevated blood pressure
- Fast heart rate
Without proper treatment, the spasms and stiffness can get worse. They may spread to other parts of the body like the arms, legs, and stomach muscles. Other complications can include:
- Bone fractures – from sustained muscle contractions
- Laryngospasms – spasms of the vocal cords that affect breathing
- Pneumonia – from breathing difficulties and aspiration
- Breathing difficulty
- Dangerously high blood pressure
- Irregular heart rhythms
What Happens Over Time Without Treatment
If tetanus is left untreated, the toxin will continue to affect the nervous system. Muscle spasms and rigidity worsen over time. They can become powerful enough to cause bone fractures. Muscle spasms may also interfere with breathing. As breathing becomes more difficult, it can lead to respiratory failure, pneumonia, and death. Usually, the respiratory muscles are affected within 5 to 10 days after symptoms begin.
Other life-threatening complications of untreated tetanus include:
- Blood clots – due to immobility
- Pulmonary embolism – blood clots that travel to the lungs
- Sepsis – the body’s extreme response to infection
- Kidney failure
- Heart failure
Without treatment, about 1 in 5 tetanus cases are fatal. Death usually occurs within 3 weeks of symptom onset. The mortality rate is highest in infants and older adults.
Timeline of Untreated Tetanus
Here is a general timeline of what to expect as tetanus progresses without treatment:
| Time Period | Symptoms and Complications |
|---|---|
| Days 1-7 | Muscle stiffness and spasms develop, usually starting in the jaw. Difficulty swallowing and neck rigidity occur early on. |
| Week 1 | Spasms spread to other muscle groups. Breathing becomes rapid. Blood pressure and heart rate increase. |
| Week 2 | Severe bodywide muscle spasms worsen. Spasms are strong enough to cause bone fractures. Breathing muscles are affected. Respiratory failure is imminent. |
| Week 3 | Respiratory failure leads to death in many untreated cases. Other life-threatening complications like sepsis, kidney failure, and heart failure may also occur. |
Prevention Through Vaccination
Thankfully, tetanus is preventable through vaccination. Doctors recommend DTaP vaccine in childhood and Tdap booster shots every 10 years in adulthood. The vaccines work by producing antibodies that neutralize the tetanus toxin so it cannot act on nerves. Even if you get a tetanus-prone wound, vaccination prevents the toxin from causing symptoms.
If you sustain a tetanus-prone injury and have not had a Tdap booster in the past 10 years, your doctor may give you tetanus immune globulin for immediate short-term protection. But you will still need to get the Tdap vaccine to be fully protected long-term.
Prompt Treatment
If tetanus symptoms do develop, prompt medical care is critical. Treatment involves:
- Wound care
- Medications to neutralize unbound toxin
- Antibiotics
- Tetanus immune globulin injection
- Medications to control muscle spasms
- Breathing support if needed
With intensive care, the mortality rate for tetanus drops significantly to 10-20%. Recovery takes 4-6 weeks. But long-term complications like muscle weakness may persist.
Conclusion
Tetanus is a potentially fatal infectious disease that has a high mortality rate if left untreated. The tetanus toxin progressively leads to severe, painful muscle spasms that impair breathing and cause other life-threatening complications. Vaccination is key to preventing the disease. If tetanus does develop, immediate medical treatment is critical to counteracting the toxin and supporting vital functions.