Tetanus exhibits a wide spectrum of clinical severity. About 60% of the cases are benign and the patients will recover, whatever the treatment; it is necessary that therapeutic trials be carried out within matched groups when the effects of new drugs or procedures are to be evaluated. Since the mere existence of muscular hypertonia and paroxysmal spasms does not in itself indicate an unfavorable outcome, and the incubation and "onset" time are valueless in the individual patient, the author analyzed a series of 84 cases of tetanus. He describes the clinical aspects more commonly found in the severe forms of the disease.
Kloetzel K. Clinical Patterns in Severe Tetanus. JAMA. 1963;185(7):559–567. doi:10.1001/jama.1963.03060070027018
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