UMEM Educational Pearls

Title: Tetanus

Posted: 12/5/2012 by Walid Hammad, MD, MBChB (Updated: 5/2/2024)
Click here to contact Walid Hammad, MD, MBChB

40 yo previously healthy male in China who presents with prolonged “seizure” after receiving a cut on his foot while fishing 5 days ago.

Dx: Tetanus

Clinical features:

· Incubation period 4-14 days

· 3 clinical forms:

1. Local spasm

2. Cephalic (rare) - cranial nerve involvement

3. Generalized (most common) - Descending spasm: facial sneer (risus sardonicus), “locked jaw” trismus, neck stiffness, laryngeal spasm, abdominal muscle spasm.

· Spasms continue to 3-4 weeks and can take months to fully recover

Complications: apnea, rhabodymyolysis, fracture/dislocations

Treatment: supportive, benzodiazepines, RSI, Tetanus IG (3000-5000 units IM), wound debridement

University of Maryland Section for Global Emergency Health

Author: Veronica Pei, MD

References

http://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html