Factors Associated with a Poor Prognosis in Tetanus

Tetanus is a nervous system disorder characterized by muscle spasms that is caused by the toxin-producing anaerobe, Clostridium tetani, which is found in the soil.

Patients with shorter incubation periods have increased disease severity and mortality. There are some factors associated with a poor prognosis in tetanus:

Adult Tetanus Neonatal Tetanus
Age >70 years Younger age, premature birth
Incubation period <7 days Incubation period <6 days
Short time from first symptom to admission Delay in hospital admission
Puerperal, IV, postsurgery, burn entry site Grass used to cut cord
Period of onseta <48 h 
Heart rate >140 bpmb 
Systolic blood pressure >140 mmHgb 
Severe disease or spasmsb 
Temperature >38.5°Cb 

a Time from first symptom to first generalized spasm.

b At hospital admission.

Harrison's Principles of Internal Medicine 18th Edition

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