title: A forgotten diagnosis in emergency department: tetanus.
abstract: BACKGROUND
  Tetanus is a serious and acute life-threatening disease caused by toxins of "Clostridium tetani". Although it is generally a disease of developing countries, its lower incidence is encountered also in developed countries. Since the principal treatment of this disease is known to be based on vaccination and wound care, the emergency physicians play a key role in its management.
  
  
  METHODS
  In the present study, we reviewed its uncommon clinical course along with demographic and clinical features of five cases that have presented with various complaints to our Emergency Department. Presenting signs, demographic features, injury history, and the time from the occurrence of injury to the beginning of symptoms were evaluated.
  
  
  RESULTS
  Four of five cases were female. The mean age of cases was 56.8 (34-73). Three of them had hand injury, one had foot injury, and the fifth case had facial injury. The initial symptoms included difficult jaw movement, back muscle spasm, and pain. Two cases died.
  
  
  CONCLUSIONS
  Tetanus cases may present to ED with different symptoms. Therefore, physicians should be aware of the early signs of tetanus. Careful and meticulous wound management of cases presented to ED following an injury should be considered a significant factor, which can help in reducing the tetanus cases (Tab. 2, Ref. 18).
authors.affiliation: Department of Emergency Medicine, Erciyes University Faculty of Medicine, Kayseri, Turkey. oakdur@hotmail.com
authors.forename: O
authors.initials: O
authors.lastname: Akdur
authors.forename: S
authors.initials: S
authors.lastname: Ozkan
authors.forename: P
authors.initials: P
authors.lastname: Durukan
authors.forename: M
authors.initials: M
authors.lastname: Koyuncu
authors.forename: I
authors.initials: I
authors.lastname: Ikizceli
authors.forename: G
authors.initials: G
authors.lastname: Metan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013742:Tetanus / Q000175:diagnosis* / Q000628:therapy; D014951:Wounds, Stab / Q000150:complications