DOI: 10.36347/sjmcr.2017.v05i11.028

Pages: 783-785

An 82-year-old man with a left forearm injury due to a motorcycle accident waited 1 month to visit a medical facility. Three weeks after the accident, he experienced difficulty opening his mouth, and this symptom gradually worsened. As he had sign of trismus and inflammation in addition to no causative diseases involving the oral or temporomandibular joints, he received a diagnosis of tetanus and was treated with human tetanus immunoglobulin and Penicillin G at 12 million units per day. An incision was later performed to drain the collected fluid. After these treatments, his forearm and lockjaw completely subsided within 10 days. Both microscopic findings and culture of the fluid were negative for Clostridium tetani. The diagnosis of tetanus is clinical with no particular laboratory test. Key features to note when diagnosing tetanus include acute or subacute onset and muscle contracture, such as trismus, with no other medical cause.