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Sinusitis, completed Keflex and Azithromycin. Cut in the hand due to scissors, applied neosporin, alcohol. Got Adacel instead of Td. Possible tetanus infection ?

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Good evening. I'm 29 years old, 6'2", 185 lbs and a bit of a hypochondriac.. My question relates to tetanus but first a brief history: I had routine tetanus shots as a child with my last booster being somewhere around age 16-17 (before Adacel was released in 2005). It may be irrelevant but for the past 10 weeks I've been battling some bad sinus stuff, diagnosed as sinusitis twice.. I completed a Keflex cycle and an Azithromycin cycle in the past 10 weeks along with using a fluticasone propionate nasal inhaler. I've also had a large canker sore in my mouth for 3 weeks. Monday morning around 9am I accidentally cut my left hand with some household scissors (pic attached). I immediately ran warm tap water over the small wound, applied pressure with a paper towel and put neosporin on it. Two orders later I put rubbing alcohol on it and about 4 hours after that I poured a few drops of hydrogen peroxide on it (I did this 3 times over the next 24 hours). I became concerned about the potential for tetanus infection and when I found out it had been 10-12 years since my last booster shot I was even more concerned. Tuesday at 2pm I decided to go get a booster shot, I thought I was just getting a Td booster but ending up getting Adacel instead. Tuesday evening I noticed my arm feeling a little tense with a weird heavy feeling in my left arm (cut arm, not shot arm) and a strange tense pain behind and above my left elbow. My right arm is a little sore as to be expected but I'm concerned about ongoing intermittent tension in my left arm, left shoulder (cut arm, not shot arm) along with some other sensations I think I feel in my neck and jaw muscles. My biggest obstacle is not knowing what's real vs. what I read online and made happen to myself. I live close to an Urgent Care facility that closes at 8pm EST, I'm new to the area and don't have a PCP. My nearest ER is 45 mins away. Are my concerns well founded or am I being silly?
Posted Sat, 5 May 2012 in General Health
Answered by Dr. Rakhi Tayal 2 hours later

Thanks for posting your query.

After the injury since you have taken adacel, your chances of getting a tetanus infection are minimized. The symptoms you are having in your elbow or shoulder might be a general muscle fatigue or spasm or due to abnormal hand position as a protective gesture after the injury.

There is nothing alarming. You need not rush to an ER. You can take a mild over the counter pain killer like acetaminophen or ibuprofen. You can take one tablet every 4-6 hourly to reduce the inflammation and pain. Your symptoms will most likely subside in a day or two. If the symptoms persist then you need to get yourself evaluated by your general physician.

Hope this answers your query. I will be glad to answer the follow up queries that you have.


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Follow-up: Sinusitis, completed Keflex and Azithromycin. Cut in the hand due to scissors, applied neosporin, alcohol. Got Adacel instead of Td. Possible tetanus infection ? 15 hours later
Thank you.. a few follow up questions:

-I've noticed my muscles "jumping" a little this morning, mainly in my thigh muscles, back and chest. How can I can distinguish twitching from spasms?

-Would the Azithromycin I finished 3 weeks ago factor in to this in any way either by A) reducing the effectiveness of the Adacel or B) making my body more susceptible to a tetanus infection. Would the coritcosteroid nasal spray I used a few days prior to the Adacel shot reduce it's effectiveness?

-Having the Adacel shot approx 30 hours after my cut, should I have peace of mind that this will protect me from anything in this current cut?

-Is there a certain amount of time that I can take comfort in passing following this cut to know 100% that I am no longer at risk for tetanus?

-Has the Adacel shot ever given someone tetanus?

Thank you!
Answered by Dr. Rakhi Tayal 8 hours later

Thanks for writing again.

1. Twitches are repeated irregular muscle contractions and relaxations while spasms are continuous contracted state of muscles.

2.Azithromycin and steroid nasal spray a few times does not affect the efficacy of adacel shot or make you more susceptible for tetanus infection.

3. Adacel shot taken within 30 hours of injury does provide you a considerable safety against tetanus. Please do not worry.

4. If you are infected then the symptoms of tetanus are evident within 5-7 days.

5. There are no such documented evidences that such vaccination itself can cause tetanus specially when you have been immunized earlier till 17 years of age.

Hope my answer is helpful. Write back if you have further queries.

Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by
Follow-up: Sinusitis, completed Keflex and Azithromycin. Cut in the hand due to scissors, applied neosporin, alcohol. Got Adacel instead of Td. Possible tetanus infection ? 19 hours later
Thank you.. would taking a certain antibiotic provide me with 100% certainty?

My muscles continued to twitch and be sore in certain areas this morning.. particularly in my left knee. My neck has also felt tight but I understand that many of these symptoms can simply be from stress. I'm obviously fearful of the uncertainty and would love to do something to be 100% sure I'm okay.. even if it's taking a certain antibiotic that may turn out unnecessary.

It's hard to imagine just waiting on a certain amount of time to pass to see if I'm okay or not.

Thanks again..
Answered by Dr. Rakhi Tayal 6 hours later

You are actually deeply stressed out. To be 100% sure, taking tetanus immunoglobulin will actually help you in fighting off the tetanus infection under the guidance of your physician. Taking any antibiotic will not help you much.

You can consult your physician for prescription and proper administartion.

Just relax and take a good care of yourself.

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