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Case Reports
. 2016 Feb 11:2016:bcr2015213897.
doi: 10.1136/bcr-2015-213897.

Trismus, the first symptom in a challenging diagnosis of Tetanus

Lorenzo Giannini  1 , Alberto Maccari  1 , Valentina Chiesa  2 , Maria Paola Canevini  2
Affiliations
Case Reports

Trismus, the first symptom in a challenging diagnosis of Tetanus

Lorenzo Giannini et al. BMJ Case Rep. .

Abstract

Tetanus is a severe, life-threatening infectious disease present worldwide. The incidence of this disease is very low in developed countries, and practitioners are unfamiliar with its symptoms and signs, resulting in late diagnosis and low recovery rate. Furthermore, main symptoms, such as trismus, are often associated with several confounding factors: these may lead the physician to send patients towards an incorrect diagnostic management and the calling on of wrong specialists. This case focuses on the importance of considering tetanus in the differential diagnosis of trismus associated with systemic symptoms, and discusses the clinical implications of an initial wrong diagnostic pathway.

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Figures

Figure 1
Figure 1
Oral examination in moderate trismus: the floor of the mouth is cumbered by a central haematoma, surrounded by hyperaemia; complete mandibular edentulism is present.
Figure 2
Figure 2
CT scan, sagittal plane: evidence of an oral, hypodense mass, situated deeply in the body of the tongue.
See this image and copyright information in PMC

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