Sugiura Tsutomu, Yamamoto Kazuhiko, Sato Masatoshi, Kirita Tadaaki
Department of Oral and Maxillofacial Surgery, Nara Kasuga Hospital, Nara, Japan.
Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan.
Contemp Clin Dent. 2017 Oct-Dec;8(4):642-644. doi: 10.4103/ccd.ccd_259_17.
Tetanus has become rare in industrialized countries, largely due to the effectiveness of immunization. However, the elderly are susceptible to tetanus because many have not received primary immunization; the incidence of tetanus in Japan is still 120 cases/year. The initial symptoms of tetanus, such as trismus and dysphagia, are observed in the orofacial region. However, because of the disease's rarity, the clinician may be unfamiliar with the clinical presentation and may not suspect tetanus. We report two cases of elderly patients with generalized tetanus. Both patients presented trismus and/or dysphagia and consulted three different departments before the diagnosis of tetanus. Japanese clinicians will encounter tetanus more frequently than practitioners in other countries. Dental surgeons should be familiar with the clinical appearance of tetanus and should consider this disease in a nonimmunized patient presenting as an atypical case of trismus and dysphagia.
破伤风在工业化国家已变得罕见，这主要归功于免疫接种的有效性。然而，老年人易患破伤风，因为许多人未接受过基础免疫；日本破伤风的发病率仍为每年120例。破伤风的初始症状，如牙关紧闭和吞咽困难，出现在口面部区域。然而，由于该疾病较为罕见，临床医生可能不熟悉其临床表现，因而可能不会怀疑是破伤风。我们报告两例老年全身性破伤风患者。两名患者均出现牙关紧闭和/或吞咽困难，并在破伤风诊断之前辗转咨询了三个不同科室。相较于其他国家的医生，日本临床医生会更频繁地遇到破伤风病例。牙科医生应熟悉破伤风的临床表现，对于出现牙关紧闭和吞咽困难非典型病例的未免疫患者应考虑到该病。
