### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, I am wondering if I may have a mild form of tetanus. I impaled the sole of my foot about 3 weeks ago on a metal belt-buckle tine ( about 1/4 in in diameter and 3/4 in long). There was no bleeding so I initially didn t think it pierced the skin although I could feel and hear it enter, like an awl through leather. After looking at the wound under a microscope light I could see a clear + shaped entry. It produced a rather large bruise on the top of my foot for a week or so but that was it. I didn t think anything of it at the time but since have had weird symptoms including: sudden lump in throat and trouble swallowing ( went for dinner with my girlfriend last week and coudn t eat - thought I was going to choke so got a doggie bag) - I thought maybe strep so got anti-b s for that yesterday. Trouble is the swab won t be accurate as I self-medicated with some penicillin I had in the house for a couple of days prior trying to relieve my symptoms. Also, a severe and sudden onset of back pain lasting several days, x-rays showed nothing and it eventually subsided. Slight temp for several days now and also I have frequent ( every 15 - 30 min ) of flash heat/sweating and I know its not menopause as I just had my hormones checked and all is normal. I thought after 6 doses of anti-b s all would be fine but no. I feel like crap, can t get up in the morn and just want to know if I should be thinking of tetanus as the culprit. I don t think I ve had a tetanus shot for about 8 years or more. Had stitches about 7 years ago and remember telling the ER staff that I had had tetanus a couple of years prior so didn t get another at that time. Should I be concerned? The initial wound on the sole of my foot is pretty much healed, no infection that I can tell...a little tender but I am walking on it...just a 1/4 in scab under the skin. Do you think I should go back to the doc? I meant to ask about the foot injury at my last visit but thought it would sound silly. thanx

### output:

Hello. Tetanus is a fatal disease without life support caused by a bacterial toxin. Initially toxin is formed near wound area and later toxin spreads to whole body. Features are irritability, restlessness, locked jaw, fever, initial muscle spasm in the throat and jaw later spread to whole body including respiratory muscles.  So until toxin is removed using antitoxins patient has to b put on respiratory support.  According to your description difficulty of swallowing is only one episode. Tetanus is a progressive disease, so you can't have only one episode of muscle spasm. Fever and chills are may be due to the throat infection. Some of your symptoms are related with anxiousness too.  Anyway it is better to get your blood tests done as soon as possible complaining your worries to the doctor. Hope this helps. Thank you.