June 1981

Cephalic Tetanus as a Complication of Nasal Foreign Body

Author Affiliations

Department of Pediatrics Wayne State University and Children's Hospital of Michigan Detroit

Am J Dis Child. 1981;135(6):571-572. doi:10.1001/archpedi.1981.02130300069025

Tetanus, a disease of global importance, is relatively uncommonly encountered in the United States. However, the mortality in reported cases of tetanus is higher in the United States than in the developing countries.1 Early recognition and intensive supportive management are vital for survival. Cephalic tetanus is an unus

ual form of the disease and has been described as a complication following head injury.2 This report describes an occurrence of cephalic tetanus secondary to a nasal foreign body in an unimmunized child.

Report of a Case.—A 2-year-old girl had unilateral nasal discharge of two days' duration. A match stick was removed from the right nostril. She returned the next day with fever, irritability, and inability to open her mouth. Examination revealed trismus and opisthotonos. The child had received no immunizations. Lumbar puncture and tests for phenothiazines and strychnine in blood and urine were negative. The clinical diagnosis of

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