Acute aspiration and trismus due to tetanus

HNO
A BlumK Hörmann

Abstract

Tetanus is a worldwide health problem, causing the deaths of approximately 1,000,000 people every year. In Germany, about 15 infections are reported annually. The initial symptoms often develop in the head and neck region. As a result, some patients are referred to the otorhinolaryngologist. We report on a 83 year old female who suffered from recurrent aspiration and trismus. She had acquired a small injury on her lower leg 2 weeks earlier; protective antibody levels did not exist. The neurophysiological examination showed a result typical of tetanus. The patient received tetanus immunoglobulin, metronidazole and benzodiazepines. Due to respiratory problems, tracheotomy and ventilation became necessary. Elderly people often lack protective antibody levels against tetanus. If typical symptoms are manifest, tetanus has to be considered as a possibility. A complete history, including recent injuries and past vaccinations, should be compiled.

References

Oct 1, 1992·The Journal of Laryngology and Otology·J Ross, N J Murrant
May 12, 2001·The Journal of Emergency Medicine·S S Hsu, G Groleau
Jan 10, 2003·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Kemalettin AydinIftihar Koksal

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European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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