A case of generalized tetanus with classical ‘risus sardonicus’

Abstract

A 50-year-old farmer presented with dysphagia and chest tightness following foot trauma for the last three days. On examination, he had nuchal rigidity, trismus, and hypertonia. A characteristic ‘Risus Sardonicus’ face was noticed (Figure 1). The patient also developed generalized painful spasms and respiratory distress with stridor, following which an urgent tracheostomy was done. Based on clinical presentation, a clinical diagnosis of generalized tetanus was considered. He was given 0.5 ml intramuscular tetanus toxoid and 3000 IU of human tetanus immunoglobulin.