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Grading of severity of tetanus

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Grading of severity of tetanus

Grade 1 (mild)

  • mild to moderate trismus and/or general spasticity, little or no dysphagia, no respiratory embarrassment.

Grade 2 (moderate)

  • moderate trismus and general spasticity, some dysphagia and respiratory embarrassment, and fleeting spasms occur.

Grade 3a (severe)

  • severe trismus and general spasticity, severe dysphagia and respiratory difficulties, and severe and prolonged spasms (both spontaneous and on stimulation).

Grade 3b (very severe)

  • as for severe tetanus plus autonomic dysfunction, particularly sympathetic overdrive

Localised tetanus is rigidity and spasms confined to the area around the site of the infection and may be more common in partially immunised individuals

  • localised symptoms can continue for weeks or may develop into generalised tetanus.

Reference:

  • UK Health Security Agency (September 2023). Guidance on the management of suspected tetanus cases and the assessment and management of tetanus-prone wounds

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