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The Jaw-Locking Case of a Missed Tetanus Booster
Erica Westlake1, Katherine Billings2, Ann McMoran1
1Cooper University Hospital, Department of Emergency Medicine, Camden, New Jersey.
Clinical Practice and Cases in Emergency Medicine
|May 22, 2025
Summary
Tetanus, a rare disease, can be diagnosed clinically and treated effectively with immunoglobulin, antibiotics, and immunization. Prompt treatment of this serious condition prevents fatal complications like airway compromise.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Neurology
Background:
- Tetanus is a rare but serious neurotoxic disease caused by Clostridium tetani.
- Widespread vaccination has significantly reduced tetanus incidence.
- Diagnosis relies on clinical suspicion due to lack of rapid diagnostic tests.
Observation:
- A young male presented with generalized spasms and trismus following untreated lacerations.
- The patient had not received tetanus immunization since 2008.
- Clinical presentation suggested tetanus, prompting immediate medical intervention.
Findings:
- Treatment included intravenous immunoglobulin, tetanus toxoid immunization, metronidazole, and ceftriaxone.
- Laboratory findings revealed rhabdomyolysis and elevated lactate levels.
- Imaging studies were unremarkable, supporting a clinical diagnosis.
Implications:
- This case highlights the importance of maintaining tetanus immunization, especially after injury.
- Early recognition and multidisciplinary treatment are crucial for favorable outcomes.
- Tetanus, though rare, remains a critical diagnosis in emergency settings, necessitating prompt management to avoid mortality.
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