Generalized tetanus despite prior vaccination and a protective level of anti-tetanus antibodies

Because of the success of widespread vaccination, tetanus rarely occurs in developed countries such as the United States. Vaccination, however, is not entirely protective even if patients develop an adequate antibody response. We discuss a case of generalized tetanus in an individual with both a history of prior vaccination and a measurable level of anti-tetanus antibodies at the time of presentation. We speculate that the patient's preexisting antibodies may have moderated his course of illness.