Bleck reported a severity scale for tetanus. It appears to be based on previous scores such as the score of Gallais et al (above).
Parameters:
(1) incubation period in days
(2) onset period in hours (time from first sign to full evolution)
(3) source of exposure
(4) generalized tetanus
(5) core body temperature in °C
(6) tachycardia in beats per minute
|
Parameter |
Finding |
Points |
|
incubation period |
>= 7 days |
0 |
|
|
< 7 days |
1 |
|
onset period |
>= 48 hours |
0 |
|
|
< 48 hours |
1 |
|
exposure |
burn, umbilical stump, surgical wound, compound fracture, septic abortion, intramuscular injections |
1 |
|
|
other |
0 |
|
generalized tetanus |
no |
0 |
|
|
yes |
1 |
|
temperature |
<= 40°C |
0 |
|
|
> 40°C (> 104°F) |
1 |
|
tachycardia |
<= 120 beats per minute AND adult |
0 |
|
|
> 120 beats per minute AND adult |
1 |
|
|
<= 150 beats per minute AND neonate |
1 |
|
|
> 150 beats per minute AND neonate |
0 |
where:
• Fever and tachycardia may be manifestations of autonomic dysfunction.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the more severe the tetanus.
|
Total Score |
Tetanus Severity |
|
0 to 1 |
mild |
|
2 or 3 |
moderate |
|
4 |
severe |
|
5 or 6 |
very severe |
Additional types of tetanus considered severe or very severe:
(1) neonatal (very severe)
(2) cephalic tetanus (severe or very severe)
(3) associated with narcotic addiction
Specialty: Infectious Diseases, Surgery, general, Surgery, orthopedic, Emergency Medicine
