title: A case of otogenic tetanus.
abstract: The authors are presenting our experience of managing an interesting case of a 12-year-old girl who presented to our clinic with otorrhea for 3 months and trismus for 1 week. Examination showed bilateral ear discharge with central perforations in tympanic membranes, palatal paralysis and trismus. Systemic examination revealed only mild stiffness of hand muscles. CT-scan head and neck was done to look for intracranial complications of otitis media. However; it revealed only decreased pneumatisation of mastoid cells. She was admitted in the hospital and started on intravenous and local antibiotics after sending ear swab and blood cultures. But she showed no improvement in 48 h. So on the clinical suspicion (trismus and stiffness of hands) remote possibility of otogenic tetanus was considered and she was given tetanus toxoid and immunoglobulins. She gradually showed improvement in her symptoms. Thereafter, culture from ear discharge was also reported positive for Clostridium tetani.
authors: Otorhilaryngology Head & Neck Surgery Department, Aga Khan University Hospital, Karachi, Sindh, Pakistan. doc.adeel.khan@gmail.com
authors: Mohammad
authors: M
authors: Adeel
authors: Shaheryar Ahmed
authors: SA
authors: Rajput
authors: Muhammad Sohail
authors: MS
authors: Awan
authors: Asif
authors: A
authors: Arain
mesh_terms: D002648:Child; D003017:Clostridium tetani / Q000302:isolation & purification*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D013742:Tetanus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D013745:Tetanus Toxoid / Q000627:therapeutic use; D014313:Trismus / Q000382:microbiology*; D018058:Tympanic Membrane Perforation / Q000382:microbiology*
chemical_list: D007136:Immunoglobulins; D013745:Tetanus Toxoid