Tetanus of suspected dental causality

Unusual generalized tetanus evolving from odontogenic infection: A case report and review of recent literature

“…Wound swabs for microscopy, culture and sensitivity tests may be performed, but the result may not strongly indicate the presence or absence of the organism [ 11 , 18 , 20 ]. Although C. tetani is among the easiest bacteria to identify once isolated, culturing them from surgical material or wounds often presents certain difficulties due to the paucity of organisms usually present in wounds [ 6 , 14 , 16 ]. Culturing of C. tetani is frequently unsuccessful, with cultures only being successful 30% of the time, and negative results do not eliminate the diagnosis [ 8 , 11 , 14 , 18 ].…”

“…In Table 1 , several cases of the odontogenic origin of tetanus caused by dental procedures, such as tooth extraction, root canal therapy, or injection of an anesthetic, are presented [ 7 , 8 , 9 ]. Moreover, other cases have also reported gross caries, periodontal abscess, or intraoral soft tissue trauma as presumed origin [ 6 ]. In one single-center retrospective study of 17 tetanus cases in China, Fan et al reported that the maxillofacial region was the point of entry of C. tetani in 5.9% of all cases [ 24 ].…”

“… References Country Patient’s Age Suspected point of entry Clinical manifestation Bacterial culture Diagnosis Outcome Baviskar et al. [ 6 ] Mumbai 27 years old Local anesthetic injection for carious left maxillary second premolar. Trismus, dysphagia, neck and back rigidity, generalized spasm.…”

“…In the absence of these factors, many physicians often do not consider tetanus as the differential diagnosis. To date, only a few studies have discussed the odontogenic origin of tetanus, with the presumed origin being a result of one of the following: tooth extraction, root canal therapy, injection of anesthetic, gross caries, periodontal abscess or intraoral soft tissue trauma [ 6 , 7 , 8 , 9 , 10 , 11 ]. In the present case report, a case of generalized tetanus of presumed odontogenic origin is presented.…”

Generalized tetanus in a landscaper without obvious wounds

“…This is followed by painful spasms in other muscle groups in the neck, trunk, and extremities. The spasms of facial muscles give the classic “risus sardonicus” and the back contraction leads to arching of back or opisthotonus [ 7 ]. In severe cases, the patients exhibit symptoms of autonomic overactivity such as sweating, tachycardia, arrhythmias, labile blood pressure, and fever [ 8 ].…”