Trismus caused by cephalic tetanus Case report
Journal Title: ΑΡΧΕΙΑ ΕΛΛΗΝΙΚΗΣ ΣΤΟΜΑΤΙΚΗΣ ΚΑΙ ΓΝΑΘΟΠΡΟΣΩΠΙΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ - Year 2016, Vol 17, Issue 1
Abstract
Trismus is defined as the inability to open the mouth. Several diseases and conditions are included in its differential diagnosis, such as infections, trauma, neo- plasms, temporomandibular joint disorders. Cephalic tetanus is a rare form of tetanus that is limited to the area of the head and neck; trismus can be the first symp- tom of the disease. Case presentation: A 77-year-old male patient with a non- contributory medical history, presented with a gradually deteriorating ability to open his mouth. He underwent a full set of tests, and there were no pathological findings. The tongue depressor test, in which the instrument touches the nasopharyngeal mucosa, was positive for tetanus, as in this case it caused trismus instead of vomiting reflex. The patient was treated with metronidazole intravenously and received active and passive immunization against clostridium tetani. His clinical condition improved and he was discharged after 10 days. Conclusion: Cephalic tetanus is a rare but potentially life-threatening cause of trismus. Physicians should maintain a high index of suspicion in cases of trismus, in order to make an early diagnosis of the disease, provide effective treatment in a timely manner and prevent complications.
Authors and Affiliations
Spyridon ATHANASIOU, Konstantinos MOUROUZIS, Andreas MARKETOS, Sofia TSAOUSI, Moisis LELEKIS, George RALLIS
Keywords
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