infectious diseases
Tetanus
Diagnosis of Tetanus
Clinical evaluation Tetanus should be considered when patients have sudden, unexplained muscle stiffness or spasms, particularly if they have a history of a recent wound or risk factors for tetanus. Tetanus can be confused with meningoencephalitis of bacterial or viral origin, but the following combination suggests tetanus: An intact sensorium Normal cerebrospinal fluid Muscle spasms Trismus must be distinguished from peritonsillar or retropharyngeal abscess or another local cause. Phenothiazines can induce tetanus-like rigidity (eg, dystonic reaction, neuroleptic malignant syndrome). C. tetanican sometimes be cultured from the wound, but culture is not sensitive; only 30% of patients with tetanus have positive cultures. Also, false-positive cultures can occur in patients without tetanus. 