Most common form of tetanus is generalized tetanus, in which toxins enter

Clinical Features → Most common form of tetanus is generalized tetanus, in which toxins enter the lymphatics and bloodstream.  → Median time of onset after injury is 7days. → First symptom– Pain and tingling at the site of inoculation.  → Early sign– increased tone of masseter muscles called as trismus/lock jaw, followed by sequential involvement of nerves of head, trunk and extremities (Descending tetanus). → Sustained contraction of facial muscles results in risus sardonicus. → Deep tendon reflex increase.  → Short incubation period = Grave prognosis . → Neonatal tetanus is a rare form, with high mortality, it may occur after head injury or ear infection.