We describe a patient presenting with altered mental state, generalised stiffening of the body and limbs as a result of acute generalised tetanus. Discussion of the clinical manifestations, diagnosis, initial management in the emergency department and complications is put forth.
EdlichR.F., HillL.G., MahlerC.A., CoxM.J., BeckerD.G., HorowitzJ.H.Management and prevention of tetanus.J Long Term Eff Med Implants2003; 13(3): 139–54.
2.
ScherK.S., BalderaA., WheelerW.E., WalkerR., JonesC.W.Inadequate tetanus protection among the rural elderly.South Med J1985; 78(2): 153–6.
PhillipsL.A.A classification of tetanus.Lancet1967; 1(7501): 1216–7.
12.
AbrahamianF.M.Tetanus: an update on an ancient disease.Infect Dis Clin Pract2000; 9: 228–35.
13.
TrujilloM.H., CastilloA., EspanaJ., ManzoA., ZerpaR.Impact of intensive care management on the prognosis of tetanus. Analysis of 641 cases.Chest1987; 92(1): 63–5.
14.
AhmadsyahI., SalimA.Treatment of tetanus: an open study to compare the efficacy of procaine penicillin and metronidazole.Br Med J1985; 291(6496): 648–50.
15.
Ganesh KumarA.V., KothariV.M., KrishnanA., KarnadD.R.Benzathine penicillin, metronidazole and benzyl penicillin in the treatment of tetanus: a randomized, controlled trial.Ann Trop Med Parasitol2004; 98(1): 59–63.
16.
EdmondsonR.S., FlowersM.W.Intensive care in tetanus: management, complications, and mortality in 100 cases.Br Med J1979; 1(6175): 1401–4.