顎関節症状を主訴として受診した破傷風を疑う1例

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Tetanus has become a disease not commonly seen in Japan, but the mortality figures for the disease vary from 10 to 60 percent if unrecognized or untreated.<BR>A 32-year-old male, carpenter, was referred to our hospital with temporomandibular joint dysfunction. Examination showed moderate trismus with a maximum opening of 22 mm, and revealed spasm of the masseter. He denied a recent history of trauma. But the muscle stiffness became more generalized and involved the jaw, neck and back musculature. Tetanus was diagnosed on clinical grounds and the patient was treated.<BR>An early warning symptom of tetanus is trismus, so a patient suffering from this disease may initially consult a dentist or an oral surgeon. It is important to consider that trismus may be caused not only by local sepsis and temporomandibular joint dysfunction but by tetanus as well, although there was no obvious injury.