Otogenic tetanus is rare in the United States but occurs much more frequently in children of tropical countries. Reported mortality rates are lower than for tetanus from more common sites. However, treatment rationale and regimens should remain basically the same regardless of the anatomic location of toxin production. Tetanus must be included in the differential diagnosis for a patient presenting with otitis and muscle spasm, particularly trismus.
Black FO, Atkins CC. Tetanus From Tympanomastoiditis. Arch Otolaryngol. 1972;96(1):76-80. doi:10.1001/archotol.1972.00770090114017