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牙关紧闭作为破伤风的临床特征:病例报告。

Trismus as a Clinical Manifestation of Tetanus: A Case Report.

出版信息

J Oral Facial Pain Headache. 2016;30(4):355-362. doi: 10.11607/ofph.1703.

Abstract

Although the incidence of tetanus disease has radically declined in developed countries, both dental practitioners and oral and maxillofacial surgeons should be knowledgeable about its diagnosis since initial manifestations of the disease, such as trismus and dysphagia, are observed in the orofacial region. This study reports on a case of generalized tetanus diagnosed in a middle-aged man. Before the tetanus diagnosis, the patient had sought medical advice from seven different health care professionals, including a dentist and an oral and maxillofacial surgeon. The patient reported trismus and dysphagia as his main complaints. The suspicion of tetanus emerged from the patient's manifestations in conjunction with his history of trauma and his agricultural occupation. The patient underwent successful treatment including administration of muscle relaxants, antibiotics, and booster vaccination doses of tetanus toxoid as well as a tracheostomy and aided mechanical ventilation. This case report highlights the significance of taking a meticulous medical history, thoroughly performing a physical examination, and systematically assessing orofacial signs and symptoms.

摘要

尽管发达国家破伤风疾病的发病率已大幅下降,但牙科医生和口腔颌面外科医生都应该了解该病的诊断,因为该病的初始表现(如牙关紧闭和吞咽困难)出现在口腔颌面部。本研究报告了一例中年男子确诊的全身性破伤风病例。在诊断破伤风之前,该患者已向包括牙医和口腔颌面外科医生在内的七位不同的医疗保健专业人员寻求过医疗建议。患者主要诉有牙关紧闭和吞咽困难。破伤风的怀疑来自于患者的临床表现,结合其创伤史和农业职业。该患者接受了成功的治疗,包括肌肉松弛剂、抗生素和破伤风类毒素的加强疫苗接种剂量,以及气管切开术和辅助机械通气。本病例报告强调了详细采集病史、彻底进行体格检查以及系统评估口腔颌面部体征和症状的重要性。

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