Fillers A memorable patient

A simple case of tetanus?

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7493.710 (Published 24 March 2005) Cite this as: BMJ 2005;330:710
  1. Navin Paul (navinpaul@yahoo.com), medical officer
  1. Tomy Joseph Mannathukkaran consultant, Mar Baselious Medical Mission, Kothamangalam, Kerala, India

    A 35 year old woman from a poor family was referred to our centre with complaints of dyspnoea, difficulty in opening her mouth, and spasms affecting the extremities for three hours. She had spent the previous week caring for her only cow, a major asset for the family. The patient did not habitually wear slippers while working. Neither the patient nor her relatives had any knowledge of tetanus or tetanus toxoid vaccine. On examination, she was thinly built, anxious, conscious, and well oriented. Her respiratory rate was 36 breaths per minute with rapid and shallow breathing. She had trismus …

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