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.
Lymphatics
Blood stream
Both
None