RT Journal
A1 Wessler S, Avioli LA
T1 TEtanus
JF JAMA
JO JAMA
YR 1969
FD January 6
VO 207
IS 1
SP 123
OP 127
DO 10.1001/jama.1969.03150140075014
UL http://dx.doi.org/10.1001/jama.1969.03150140075014
AB Dr. John W. Sullivan, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and assistant in Medicine, Washington University School of Medicine: A 67-year-old white woman was admitted to the Jewish Hospital for the first time on July 30, 1968, because of shoulder and neck pain and inability to open her mouth. Eleven days before admission, a nail, thrown by a motorized lawnmower, had pierced her right calf. The nail was removed, the laceration sutured, and tetanus toxoid administered. On subsequent questioning the patient did not recall previous tetanus immunization. During the ensuing several days the patient noted a foul odor of the wound when she changed the dressing. Eight days after the injury, she first noted tightened facial muscles and a persistent pain between her scapulae. Shortly thereafter, she was unable to swallow her oral secretions. Her physician reopened the laceration, administered penicillin G potassium parenterally, and transferred