Case Report: A Challenging Case of Tetanus Presenting with Headache

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Tetanus is a rare but severe neurological condition caused by Clostridium tetani.
• Immunization campaigns have significantly reduced tetanus incidence globally.
• Untreated wounds pose a risk for tetanus development, especially in areas with limited access to prophylaxis.

Observation:

• A 43-year-old woman in Malaysia presented with headache, weakness, trismus, and neck stiffness.
• Her symptoms were linked to a foot wound from shattered glass in an unhygienic environment.
• No tetanus prophylaxis was administered prior to symptom onset.

Findings:

• The patient received tetanus immunoglobulin, tetanus toxoid, metronidazole, and sedatives.
• Neurological symptoms improved significantly following treatment.
• The patient experienced transient dysautonomia with blood pressure fluctuations.

Implications:

• This case underscores the importance of vigilant tetanus diagnosis and management, even in immunized populations.
• It highlights the severe consequences of neglecting wound hygiene and tetanus prophylaxis.
• Effective treatment and follow-up can lead to complete recovery from generalized tetanus.