[ExGeeEye]

Wikipedia:

"Tetanus...is a bacterial infection...characterized by muscle spasms. In the most common type, the spasms begin in the jaw, and then progress to the rest of the body. Each spasm usually lasts for a few minutes. Spasms occur frequently for three to four weeks. Some spasms may be severe enough to fracture bones. Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. Onset of symptoms is typically 3 to 21 days following infection. Recovery may take months, but about 10% of cases prove to be fatal.

Treatment

[no-to-illegals]

as a rule of thumb, try to get the tetanus booster shot within 48 hours of the injury

[LadyDoc]

It is infected and needs to be opened and cleaned. Sometimes we give amoxiciĺin clavulanate to stop infection from staph or strep, but this might not kill pseudomonas so at this point he might need cipro.
Most antibiotics will stop the tetanus germ too.

It sounds like there might be a small abcess beneath the tough skin of the foot. This might have to be drained by a doctor or clinic nurse. Very painful to do without xylocaine.

If he had tetanus vaccine in the past 5 to 8 years it probably will protect him.

[ScaniaBoy]

Swedish Health Care recommendations re tetanus prophylaxis in adults with wounds:

Vaccinated against tetanus?

NO: Human immunogolubline + dose 1 of vaccination

YES:

Vaccinated 1 time: Human immunoglobuline + 2nd dose of vaccine, follow up with 3d dose 6 - 12 months later

Vaccinated twice at least 6 months since latest dose: 3d dose of vaccine

3 doses of vaccine, more than 10 years since latest dose: 4th dose of vaccine

At least 4 doses of vaccine but more than 20 years since last dose: give combinations vaccine.

OK, it may be a bit late but suggest that you contact doctor. Depending on the vaccination status of the young lad, treatment as noted above.

https://vardgivarguiden.se/globalassets/kunskapsstod/smittskydd/vaccination/stelkrampsprofylax-till-vuxna-vid-sarskada.pdf

[ScaniaBoy]

Advice regarding unvaccinated children: Human immunoglobulins regardless of time from injury and appearance of wound. Follow up with vaccinations.

[GOPJ]

Get him in to see a doctor.

[JudyinCanada]

Ask him if it bled a lot when he stepped on the nail (also was the nail rusty). Usually if there is a good bleed, the blood will carry away any germs and the cut can be safely cleaned and dressed.

My kids were never vaccinated. They played outside and stepped on plenty of things. Seeing as this is someone else’s child, however, I’d probably have the doctor take a look at it. Now it’s watch and wait.

[maddog55]

They’re not your kids... Their family took them to the Drs and was treated. End of discussion.

[bert]

Orthodox Free Republic Doctrine dictates there shall be no vaccinations.

[Nifster]

Keep soaking until cleared

All else should be fine