A case report of generalized tetanus in a 42-year-old man with dental infection

Abstract

Background In the post-vaccination era, as it is today, generalized tetanus is a rare diagnosis, although mortality and morbidity continue to increase significantly throughout the world. Infection occurs when the Clostridium tetani spores are introduced into wounds, skin lesions and infections. The symptoms often begin with stiffness or spasms in the jaw muscles; they are called trismus or “lockjaw” and/or then spread to the neck and abdominal muscles. Case presentation This is a report of a 42-year-old man who was referred to the hospital with dysphagia, rigidity and trismus. He was diagnosed with generalized tetanus with a Philips score of 15. The patient was admitted to the isolation unit, received treatment that included procaine penicillin, metronidazole, diazepam, human tetanus immunoglobulin (TIG) and anti-tetanus serum (ATS). Treatment was considered according to the guidelines of the World Health Organization, and also, the drug dose has no adverse event reaction during the treatment. Conclusion The therapeutic response is related to the identification and appropriate treatment, especially in hospitalized patients with inadequate immunization so that patients recover soon.

Tetanus secondary to oral and odontogenic infections: a case report and systematic literature review

“…Furthermore, pericoronitis, deep neck infections, and traumatic injuries to maxillofacial structures can cause trismus [5,6,29]. Although such affections might be the primary cause of trismus, they could disguise superposed tetanus in some cases, especially in underlying compound mandibular fractures or facial lacerations [6,30,38]. In our study, the interval between trismus and death was relatively short (4.25±1.89 days), which is concordant with other studies [22,39].…”

Unusual generalized tetanus evolving from odontogenic infection: A case report and review of recent literature

“…To the best of our knowledge, only six cases of tetanus associated with odontogenic infection have been reported in the last decade. In Table 1 , several cases of the odontogenic origin of tetanus caused by dental procedures, such as tooth extraction, root canal therapy, or injection of an anesthetic, are presented [ 7 , 8 , 9 ]. Moreover, other cases have also reported gross caries, periodontal abscess, or intraoral soft tissue trauma as presumed origin [ 6 ].…”

“…[ 8 ] Canada 42 years old Multiple dental caries, recent tooth fracture of right upper third molar site. Trismus, dysphagia, spasm of neck, shoulder, arms, back, and legs Negative culture for C. tetani Generalized tetanus Discharged Ulfa and Husna [ 9 ] Indonesia 42 years old Dental cavities Trismus, dysphagia, rigidity. None Generalized tetanus Discharged Ajayi and Obimakind [ 10 ] Nigeria 22 years old Tooth extraction intermittent spasm of the muscles of the face and neck.…”

“…In the absence of these factors, many physicians often do not consider tetanus as the differential diagnosis. To date, only a few studies have discussed the odontogenic origin of tetanus, with the presumed origin being a result of one of the following: tooth extraction, root canal therapy, injection of anesthetic, gross caries, periodontal abscess or intraoral soft tissue trauma [ 6 , 7 , 8 , 9 , 10 , 11 ]. In the present case report, a case of generalized tetanus of presumed odontogenic origin is presented.…”

Severe tetanus following ulcerated skin cancer

“…[ 2 ] Furthermore, Tetani can also enter human body through chronic wounds, such as pressure ulcer, [ 3 ] diabetic complication, [ 1 ] and dental cavity. [ 4 ] However, cancer has been very rarely reported to result in tetanus. [ 5 – 8 ] Here, we present a rare case of severe tetanus owing to an ulcerated skin cancer on the buttock.…”