A case of tetanus without any apparent history of trauma

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  • Toshinori IWAI
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • AOKI Shinjiro
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • OKAMOTO Yoshiyuki
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • HIROTA Makoto
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • KAWABE Ryoichi
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • FUJITA Kiyohide
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine

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Other Title
  • 外傷歴のない破傷風の１例
  • ショウレイ ホウコク ガイショウレキ ノ ナイ ハショウフウ ノ 1レイ

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Abstract

We report a case of tetanus.<BR>A 78-year-old woman was referred to our hospital because of trismus. Physical examination showed severe trismus and stiffness of the masseter and temporal muscles. The patient had no noticeable history of trauma. On the next day, the symptoms intensified. Tetanus was diagnosed on the basis of clinical course and symptoms such as trismus, facial grimacing, and stiffness of the masseter and neck muscles. The patient was immediately admitted to the intensive care unit. She was given antitetanic human immunoglobulin, tetanus antitoxin, antibiotics, dantrolen, and midazolam. Opisthotonus, airway obstruction, and circulatory disturbance did not occur. The patient recovered without tracheotomy or tracheal intubation.<BR>Tetanus is a fatal infectious disease, if early treatment is not appropriately performed. We should consider the possibility of tetanus when examining patients with trismus and observe them carefully.

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