We describe two cases of tetanus.
Both patients referred to our hospital because of difficulty in mouth opening. Physical examination revealed severe trismus, dysarthria, and dysphagia in both patients. Patients had no noticeable history of trauma. The patients were given a diagnosis of tetanus on the basis of clinical course and symptoms such as rapidly progressive trismus, dysarthria, and dysphagia.
The patients were admitted to our hospital immediately. One patient was given antitetanic human immunoglobulin, tetanus antitoxin, antibiotics, and dantrolen sodium. He recovered without tracheotomy or tracheal intubation, and was discharged on the 25th hospital day. The other patient was given antitetanic human immunoglobulin, tetanus antitoxin, antibiotics, vecuronium bromide, propofol, and magnesol. A tracheotomy was performed in the latter patient because of dyspnea. He discharged on the 26th hospital day. Both patients had no functional sequelae.
Tetanus often leads to death when early diagnosis and early treatment are not appropriately performed. Oral surgeons should consider the possibility of tetanus in patients with trismus and examine them carefully.