What should I do if the tetanus test is positive?

Written by Gao Jun
Emergency Surgery
Updated on February 23, 2025
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A positive tetanus result generally refers to a positive result in the tetanus antitoxin skin test. Tetanus antitoxin is primarily used to prevent tetanus infections. Some patients may experience allergic reactions to tetanus, manifesting as localized swelling, mild fever, and general discomfort during the skin test. In such cases, a desensitization injection method can be chosen, which involves administering the tetanus shot in several doses at intervals. Alternatively, tetanus immunoglobulin can be used, which is more expensive on the market but has the advantage of not requiring a skin test. It can be administered directly, safely, and effectively.

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Criteria for a Positive Tetanus Diagnosis

After a person is injured, if the wound reaches deeper parts such as the subcutaneous fat layer or even the muscle layer, it is essential to administer tetanus antitoxin to prevent infection from tetanus bacillus. Before injecting the tetanus antitoxin, a skin test must be conducted to prevent allergies and anaphylactic shock. Generally, after injecting the test agent, observations are made for 30 minutes. If there is an enlargement of the wheal, redness and swelling that infiltrates surrounding areas, and the patient feels itching, it indicates a positive result.

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Do you need a tetanus shot for a scraped skin?

Tetanus bacterial infection generally refers to relatively deeper wounds. A deeper wound creates an anaerobic environment locally, where tetanus-causing bacteria can reproduce and grow, leading to infection. If the wound is just a scrape and not deep, it's less likely to form an anaerobic environment. In such cases, the likelihood of developing tetanus is extremely low. From personal experience, if it's just a minor scrape, simply disinfecting the area with iodine is sufficient; there is generally no need for a tetanus antitoxin injection.

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Can tetanus be fatal?

Firstly, severe tetanus, if not treated in time, can be fatal. When infected with tetanus, the early symptoms mainly include dizziness, headache, fatigue, decreased appetite, weak chewing, soreness or cramping of the jaw muscles, or muscle tension. Of course, when tetanus is severe, it can manifest as difficulty opening the mouth, risus sardonicus, opisthotonos, and stiff neck. In severe cases, there may be difficulty breathing, respiratory arrest, and even cardiac arrest. If in this situation, we do not promptly carry out emergency treatment, the tetanus patient can die.

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How many times do you need to get a tetanus shot?

If tetanus vaccination is required due to an injury, one injection is sufficient. There are two types of tetanus shots. One is called tetanus antitoxin, which is extracted from horse serum. For this, a skin test is needed to check for allergies. If allergic, tetanus antitoxin cannot be used; if not, it can be used. The other type is refined tetanus antitoxin, also known as tetanus immune globulin, extracted from human serum. This type does not require a skin test and can be used directly, but it is more expensive than tetanus antitoxin. If tetanus treatment is needed for each injury, one injection is sufficient.

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How long is a tetanus shot effective?

It is definitely better to get a tetanus shot as soon as possible, ideally within 24 hours after injury, as the chance of prevention is much higher compared to other times. Once an injury occurs, it is essential to go to a formal hospital for wound treatment, and then use disinfectant products, typically hydrogen peroxide or iodophor, to assist in disinfection. Generally, for open wounds, stitching may be necessary, but such wounds should generally not be bandaged because bandaging can lead to anaerobic bacterial infection. Since the incubation period for Clostridium tetani, the bacterium that causes tetanus, is five to seven days, an infection could potentially develop during this time. Therefore, it is advisable to get vaccinated against tetanus infection within a week. If this timeframe is exceeded, it might impact the effectiveness of the preventative measure, thus rendering it significantly less meaningful.