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A case of otogenic tetanus.
Mohammad Adeel1, Shaheryar Ahmed Rajput, Muhammad Sohail Awan
1Otorhilaryngology Head & Neck Surgery Department, Aga Khan University Hospital, Karachi, Sindh, Pakistan. doc.adeel.khan@gmail.com
BMJ Case Reports
|July 5, 2012
Summary
A 12-year-old girl with chronic ear infections developed trismus and hand stiffness. Prompt diagnosis and treatment of otogenic tetanus led to symptom improvement, highlighting a rare but serious complication of otitis media.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Neurology
Background:
- Otitis media is a common childhood infection, but can lead to serious complications.
- Tetanus, caused by Clostridium tetani, is a serious bacterial infection that affects the nervous system.
Observation:
- A 12-year-old girl presented with a 3-month history of bilateral otorrhea and a 1-week history of trismus and palatal paralysis.
- Initial management with antibiotics for presumed otitis media was ineffective.
- Clinical suspicion of otogenic tetanus arose due to trismus and hand muscle stiffness.
Findings:
- Computed tomography (CT) scan of the head and neck revealed decreased pneumatization of mastoid cells but no intracranial complications.
- Treatment with tetanus toxoid and immunoglobulins resulted in gradual symptom improvement.
- Ear discharge culture confirmed the presence of Clostridium tetani.
Implications:
- This case highlights the importance of considering rare complications like otogenic tetanus in refractory otitis media cases.
- Early recognition and appropriate management, including tetanus prophylaxis, are crucial for favorable outcomes.
- Otogenic tetanus is a critical diagnosis that requires prompt intervention beyond standard antibiotic therapy for otitis media.
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