Craniocervical Tetanus: A Practical Consideration During Work-up of Acute-Onset Trismus.
Mainak Dutta, Tanaya Panja, Indranil Dutta
✦ AI-curated · Sources linked
Case in brief
A 65-year-old farmer presented with acute-onset trismus, pareses of cranial nerves III, IX, and X, risus sardonicus, and spasms of the head and neck muscles. The clinical findings, including a positive spatula test, supported a diagnosis of craniocervical tetanus. The report reviews the characteristic features and epidemiologic context of tetanus; it does not describe the patient’s treatment or clinical outcome.
What made this case unusual
The presentation combined acute trismus with multiple cranial nerve pareses and head-neck spasms, with a positive spatula test supporting recognition of craniocervical tetanus.
Diagnostic / clinical pearl
Include craniocervical tetanus in the differential diagnosis of acute-onset trismus in adults when the clinical features and background suggest susceptibility; a positive spatula test can support recognition.
Why it matters
As tetanus has become less commonly encountered in many settings, otolaryngologists may have limited exposure to its characteristic presentation.