Cephalic Tetanus: A Rare Case Report

J Trop Pediatr. 2020 Oct 1;66(5):549-552. doi: 10.1093/tropej/fmaa004.

Abstract

Introduction: Tetanus is a preventable infectious disease with vaccination. Cephalic tetanus is the rarest form in which local tetanus can involve the cranial nerves.

Case: Herein, we report a case of cephalic tetanus in a 16-month-old girl who had never been vaccinated. The patient, who had a complaint of a wound on the cheek mucosa for 2 weeks, was seen playing with the soil in the garden 1 week ago and was found to have abundant soil removed by her mother. The patient was diagnosed as cephalic tetanus according to her complaints and clinical findings.

Discussion: We believe that, this is the first case reported in the literature of cephalic tetanus in such a young child wherein the disease focus of infection from a wound on the cheek mucosa. The symptom we defined as 'a child who cries when she smiles' presented in this case could only be associated with this disease.

Conclusion: In addition to detailed anamnesis and meticulous physical examination, the clinical symptoms that we have described for the first time in a child with cephalic tetanus should also be considered for early and accurate diagnosis.

Keywords: cephalic tetanus; cheek mucosa; child.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Cranial Nerves / microbiology*
  • Female
  • Humans
  • Infant
  • Injections, Intramuscular
  • Metronidazole / administration & dosage
  • Mouth Mucosa / injuries*
  • Penicillins / administration & dosage
  • Tetanus / diagnosis*
  • Tetanus / drug therapy
  • Tetanus Antitoxin / administration & dosage
  • Tetanus Toxoid / administration & dosage
  • Treatment Outcome
  • Wound Infection / complications
  • Wound Infection / microbiology*

Substances

  • Penicillins
  • Tetanus Antitoxin
  • Tetanus Toxoid
  • Metronidazole