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CASE REPORT
Year : 2022  |  Volume : 22  |  Issue : 4  |  Page : 226-229

Localized tetanus mimics acute perforated viscus: A diagnostic challenge and review of case reports


1 Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia; Hospital Universiti Sains Malaysia, Kelantan, Malaysia
2 Department of Emergency and Traumatology, Hospital Seri Manjung, Perak, Malaysia

Correspondence Address:
Mohamad Masykurin Mafauzy
Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjem.tjem_68_22

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Abdominal tetanus is the rarest presentation of localized tetanus in which other muscles are not involved. Proper diagnosis is challenging as it mimics acute abdomen. We describe the challenges in diagnosing this atypical localized tetanus in an adult and a review of case reports. Our patient is a 40-year-old male who presented to the emergency department with generalized abdominal pain for 3 days. His physical examination revealed a guarded abdomen with tenderness in the epigastric region, while systemic examinations were unremarkable. The initial diagnosis was acute abdomen with suspected perforated viscus. Subsequently, he developed arching of the back on day 3 of admission with markedly elevated serum creatine kinase levels. A diagnosis of localized tetanus was made, and an uneventful recovery was achieved after management. Clinicians should be aware of the atypical presentations of abdominal tetanus as it mimics acute abdomen. Early recognition and initiation of treatment significantly reduce morbidity and mortality risks.


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