Also referred to as lockjaw, tetanus is an acute exotoxin-mediated infection caused by the anaerobic, spore-forming, gram-positive bacillus Clostridium tetani. The infection usually is systemic, but it may be localized. Tetanus is entirely preventable by immunization but continues to be common in areas were soil is cultivated, in rural areas, in warm climates, during the summer months, and among males. Neonates and the elderly are prominently involved. Because reporting is incomplete, incidence is greater than statistics indicate. In the United States, most cases follow injury, such as a puncture wound, laceration, or abrasion, and are acquired outdoors.

Tetanus occurs worldwide, but it’s more prevalent in agricultural regions and developing countries that lack mass immunization programs.

Once C. tetani enters the body, it causes local infection and tissue necrosis. It also produces toxins that enter the bloodstream and lymphatics and eventually spread to central nervous system tissue.