Two Cases of Tetanus Without Visible Injury

Tetanus is a serious infection caused by the neurotoxin which is produced by Clostridium tetani. Its symptoms may progress rapidly and sometimes can be fatal, so we have to make a diagnosis and treat early. To make a diagnosis, the detection of the bacterium is important, but it is rarely possible. In many cases, we identify tetanus mostly from the history of injury and the symptoms. We report herein on two cases of tetanus without injury. The first case, a 78-year-old woman who had undergone a left submandibular glandectomy and had hypoglossal nerve paralysis, visited us with the chief complaint of dysphagia. She developed laryngospasm four days later and a tracheotomy was required. We diagnosed tetanus in the third stage, and we transferred her to a tertiary medical facility. The other case, a 68-year-old woman visited us with the chief complaints of dysphagia, neck pain, and trismus. We started treatment, and she was cured.We have to bear in mind that there are a few cases of tetanus in which the patients have no visible injury.