Sammanfattning
BACKGROUND: This case report describes the diagnostic workup, pathophysiology and management of tetanus infections. Due to the rarity of the disease in the Western world, other differential diagnoses need to be considered in patients presenting with trismus and involuntary muscle contractions.
CASE PRESENTATION: A woman in her fifties was admitted to a hospital in Norway after developing trismus and involuntary facial muscle contractions. A cat, which had previously been immunised against rabies, bit the patient on her left hand three weeks prior to the development of symptoms, and tetanus was clinically suspected. The small bite wound had nearly healed at the time of admission. The patient, who had received a tetanus booster approximately nine years earlier, was revaccinated and treated with 3000 units of human tetanus immunoglobulin, intravenous metronidazole and benzodiazepines. The patient experienced a milder infection compared to other reported tetanus cases, possibly due to previous vaccination and limited bite penetration.
INTERPRETATION: Generalised tetanus can be caused by small, seemingly benign skin injuries. Clinicians should continue to assess the need for wound care and immunisation status in individuals, including injury due to animal bites.