Primal Misdiagnosis Causes of 12 Adult Patients with Tetanus in Early Period

FANG Er-bin

doi:10.3969/j.issn.1002-3429.2014.05.001

Abstract：Objective To analyze clinical manifestations of adult tetanus in early period,and summarize the misdiag-nosis causes in order to improve accuracy of the primal diagnosis. Methods Clinical data of 12 adult patients with tetanus misdiagnosed in the primal diagnosis in our hospital was retrospectively analyzed. Results All the 12 patients had difficulties opening mouths and facial spasms in different degrees,while clear histories of trauma and chronic sinus infection were not of-fered in the first diagnosis. The patients were misdiagnosed as having convulsions of unknown origin(4 cases),cervical spon-dylosis(2 cases),lumbar spondylosis(1 case),brain neuritis(1 case),drug-induced extrapyramidal reactions(1 case), facial neuritis(1 case),cerebral infarction(1 case)and temporomandibular arthritis(1 case)in departments of general sur-gery,infectious diseases,emergency,neurology,orthopedics and dentistry respectively in the primal diagnosis. All the 12 pa-tients were confirmed of the diagnosis of tetanus after being combined with history and clinical manifestations,and were cured after corresponding treatment. All the patients had no obvious sequelae after follow-up for one year. Conclusion Adult pa-tients with tetanus without typical clinical manifestations of tetanus or definite trauma history in early period may be easily mis-diagnosed in the primal diagnosis. Patients with facial spasm and difficulties in opening mouths,especially those who were born before 1978 without DPT vaccine( whooping cough,diphtheritis and tetanus),should be more vigilant about tetanus.